Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 8573 | AZ |
N | 111NR0400X | Rehabilitation Chiropractor | 5173 | AZ |
NPI | 1003354408 |
---|---|
Provider Name | Dr. Brian Rice |
First Address | Tempe, AZ 85283-5131 |
Second Address | Chandler, AZ 85224-4354 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/02/2017 |
Last Update Date | 21/02/2017 |