Proforma Health Pllc

NPI #1326393927 in Flagstaff, Arizona

Provider Information

NPI Number: 1326393927
Entity Type: Organization
Organization Name: Proforma Health Pllc
Subpart: Yes (part of a larger organization)
Parent Organization: MUNDERLOH HOLDINGS LLC
Primary Specialty: Chiropractor
Enumeration Date: Jul 19, 2012
Last Updated: Jul 19, 2012

Practice Location

Address: 1501 S YALE ST
Address 2: SUITE 250
City: Flagstaff
State: Arizona
ZIP Code: 86001-7304
Phone: (928) 556-0707

Authorized Official

Name: DR. TIMOTHY JAMES MUNDERLOH, D.C.
Title: PRESIDENT
Phone: (928) 556-0707

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Chiropractor - Neurology — Neurology	111NN0400X
Chiropractor	111N00000X	Primary

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