Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 8767 | AZ |
N | 111NS0005X | Chiropractic Sports Physician | 8767 | AZ |
NPI | 1215407911 |
---|---|
Provider Name | Dr. David Jon Pritchard |
First Address | Phoenix, AZ 85085-1989 |
Second Address | Phoenix, AZ 85085-0809 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/11/2018 |
Last Update Date | 26/11/2018 |