100 Chiro Speterson LLC
Chiropractor in Glendale, AZ. Organization (NPI-2).
NPI number1124846597
StatusActive
Last updated in NPPESNov 7, 2024
Details
- NPI
- 1124846597
- Entity type
- Organization (NPI-2)
- Legal business name
- 100 Chiro Speterson LLC
- Organization subpart
- No
- Enumeration date
- Oct 2, 2024
- Certification date
- Nov 7, 2024
- Last updated
- Nov 7, 2024
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PART B SUPPLIER - CLINIC/GROUP PRACTICE
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 111N00000X | Chiropractor | – | – | Yes |
Practice location
20004 N 67th Ave Ste 502Glendale, AZ 85308-4623
Phone 513-544-0025
Mailing address
20004 N 67th Ave Ste 502Glendale, AZ 85308-4623
Authorized official
Steven Peterson
Owner
5135440025
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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