ARIZONA SPORTS CLINIC LLC (NPI# 1114385457) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114385457 |
| Entity Type | Organization |
| Organization Name | ARIZONA SPORTS CLINIC LLC |
| Practice Address |
5735 E Mckellips Rd Suite B-106 Mesa AZ 85215-2875 |
| Practice Telephone | 6026688109 |
| Mailing Telephone | 6026688109 |
| Enumeration Date | 2016-02-01 |
| Last Update Date | 2016-08-01 |
| Authorized Official Name | DR. TYSON WADE MAROSTICA (CHIROPRACTOR) |
| Authorized Official Telephone | 6109066164 |
| Authorized Official Credential | D.C. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | AZ | Chiropractic Providers |
| Street Address |
5735 E MCKELLIPS RD SUITE B-106 |
| City | MESA |
| State | AZ |
| Zip Code | 85215-2875 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790950988 | Cigna Healthcare of Arizona, Inc. | Clinic/Center | 5735 E Mckellips Rd, Suite 101, Mesa, AZ 85215-2875 | 2008-04-28 |
| 1750748489 | Tyson Marostica | Chiropractor | 5735 E Mckellips Rd, Ste B-106, Mesa, AZ 85215-2875 | 2016-01-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093355356 | Kristen Eldridge | Counselor | 2929 N. Power Rd. Suite 101, Mesa, AZ 85215 | 2020-01-14 |
| 1063062149 | Makenna Francis | Nurse Practitioner | 2730 S. Val Vista Dr, 146, Mesa, AZ 85215 | 2019-09-19 |
| 1487200481 | Royalty Home Care Solutions, LLC | Assisted Living Facility | 6551 E. Menlo St, Mesa, AZ 85215 | 2019-08-15 |
| 1083170641 | Mylena Dashaun Smith | Psychologist | 2812 N. Norwalk St Bldg. 14, Ste 127 & 128, Mesa, AZ 85215 | 2019-02-19 |
| 1487134789 | Arizona Dental Professionals, P.C. | Dentist | 3218 N Recker Rd, Mesa, AZ 85215 | 2018-08-16 |
| 1619463494 | Compassion Care Home, LLC | Private Vehicle | 2863 N 64th Street, Mesa, AZ 85215 | 2018-07-05 |
| 1407293491 | Courtney D Warren | Physical Therapist | 2837 N Power Rd Ste 109, Mesa, AZ 85215 | 2013-05-30 |
| 1104182906 | Kirstin Anna Correia | Naturopath | 3405 N Higley Rd, Mesa, AZ 85215 | 2012-04-05 |
| 1154609683 | Cristy Lee Hoge | Pharmacist | 2151 N. Power Rd., Mesa, AZ 85215 | 2011-08-02 |
| 1699067546 | Fredrick G. Johnson | Registered Nurse | 4320 E Presidio St, #101, Mesa, AZ 85215 | 2011-05-11 |
| Find all providers in zip 85215 | ||||
| Taxonomy Code | 111N00000X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396359626 | Adapt Chiropractic Pllc | Chiropractor | 1728 S Greenfield Rd Ste 109, Mesa, AZ 85206-3484 | 2020-09-03 |
| 1699391052 | Emily Weber | Chiropractor | 3426 E Baseline Rd, Mesa, AZ 85204-7291 | 2020-06-22 |
| 1285280099 | Mesa Chiropractic Pllc | Chiropractor | 6731 E Brown Rd Ste 101, Mesa, AZ 85205-4964 | 2019-08-16 |
| 1801352406 | Kwd Enterprises, LLC | Chiropractor | 1107 S Gilbert Rd Ste 111, Mesa, AZ 85204-5233 | 2019-02-19 |
| 1124524111 | Bryce Garst | Chiropractor | 6836 E Brown Rd Ste 102, Mesa, AZ 85207-3756 | 2018-03-30 |
| 1508369174 | Colby Ivan Davis | Chiropractor | 4904 S Power Rd Ste 105, Mesa, AZ 85212-3610 | 2018-03-09 |
| 1366953200 | Yunjae Park | Chiropractor | 1116 S Dobson Rd Ste 126, Mesa, AZ 85202-3920 | 2017-10-18 |
| 1841714631 | J. Susanne Davis | Chiropractor | 62 N. Stapley Drive, Mesa, AZ 85203 | 2017-08-02 |
| 1285179457 | Tecla Fuller | Chiropractor | 1728 S Greenfield Rd, Suite 109, Mesa, AZ 85206-3485 | 2016-12-27 |
| 1548716780 | Pain Stop Accident Injury LLC | Chiropractor | 425 E 11th Ave, Mesa, AZ 85204 | 2016-08-28 |
| Find all providers in MESA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.