Organization · NPI-2

Advanced Spine And Rehab PC

Chiropractor · Mesa, AZ

NPI number1922020858
StatusActive
Last updated in NPPESDec 17, 2025

Details

NPI
1922020858
Entity type
Organization (NPI-2)
Legal business name
Advanced Spine And Rehab PC
Organization subpart
No
Enumeration date
Jul 23, 2006
Certification date
Dec 17, 2025
Last updated
Dec 17, 2025

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
111N00000X Chiropractor5639AZYes
363LF0000X Nurse Practitioner, Family––
111N00000X Chiropractor5447AZ

Practice location

4540 E Baseline Rd Ste 111
Mesa, AZ 85206-4616

Phone 480-892-1122 · Fax 480-892-2243

Mailing address

4540 E Baseline Rd Ste 111
Mesa, AZ 85206-4616

Phone 480-892-1122 · Fax 480-892-2243

Authorized official

Michael David Crismon
Partner
4808921122

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