Palo Verde Life Center, Inc.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

4103 Issued in AZ

Legal business name

PALO VERDE LIFE CENTER, INC.

Practice address

2421 E Southern Ave
Suite 5
Tempe, AZ 85282-7612

Phone

(480) 820-3212

NPI assigned

Apr 11, 2007

Organization subpart

No

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

Authorized official

Name

Dr. David William Griesedieck, D.C.

Title

President

Phone

(480) 820-3212

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1176249600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1992928444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2421 E SOUTHERN AVE",
            "address_2": "SUITE 5",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852827612",
            "telephone_number": "480-820-3212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2421 E SOUTHERN AVE",
            "address_2": "SUITE 5",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852827612",
            "telephone_number": "480-820-3212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALO VERDE LIFE CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GRIESEDIECK",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "480-820-3212",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "AZ",
            "license": "4103",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Tempe, AZ
• Providers in Tempe, AZ by specialty
• Chiropractor in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.