Arizona Sports Clinic LLC

NPI #1114385457 in Mesa, Arizona

Provider Information

NPI Number: 1114385457
Entity Type: Organization
Organization Name: Arizona Sports Clinic LLC
Primary Specialty: Chiropractor
Enumeration Date: Feb 1, 2016
Last Updated: Aug 1, 2016

Practice Location

Address: 5735 E MCKELLIPS RD
Address 2: SUITE B-106
City: Mesa
State: Arizona
ZIP Code: 85215-2875
Phone: (602) 668-8109

Authorized Official

Name: DR. TYSON WADE MAROSTICA, D.C.
Title: CHIROPRACTOR
Phone: (610) 906-6164

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Chiropractor	111N00000X	Primary

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