Kachina Healing Center, LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

5361 Issued in AZ

Legal business name

KACHINA HEALING CENTER, LLC

Practice address

8363 E Florentine Rd
Suite C
Prescott Valley, AZ 86314-4971

Phone

(928) 772-4500

Fax

(928) 772-2622

NPI assigned

May 18, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Anthony C. Mulberg, D.C.-

Title

Member

Phone

(928) 772-4500

Specialties & licenses 3

Addresses

Other names 1

• Kachina Healing Center Other name

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1337644800000",
    "number": "1336192871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8363 E FLORENTINE RD",
            "address_2": "SUITE C",
            "city": "PRESCOTT VALLEY",
            "state": "AZ",
            "postal_code": "863144971",
            "telephone_number": "928-772-4500",
            "fax_number": "928-772-2622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8363 E FLORENTINE RD",
            "address_2": "SUITE C",
            "city": "PRESCOTT VALLEY",
            "state": "AZ",
            "postal_code": "863144971",
            "telephone_number": "928-772-4500",
            "fax_number": "928-772-2622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KACHINA HEALING CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-18",
        "last_updated": "2012-05-22",
        "status": "A",
        "authorized_official_last_name": "MULBERG",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "928-772-4500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C.-"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "AZ",
            "license": "5361",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC 23923",
            "primary": false
        },
        {
            "code": "171100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Acupuncturist",
            "state": "AZ",
            "license": "5361 - 386",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kachina Healing Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Chiropractor in Prescott Valley, AZ
• Providers in Prescott Valley, AZ by specialty
• Chiropractor in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.