Basic Information
| Provider Information | |||||||||
| NPI: | 1003833674 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ANDRIS | ||||||||
| FirstName: | JOSEPH | ||||||||
| MiddleName: | P | ||||||||
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| Credential: | DC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7225 N MONA LISA RD | ||||||||
| Address2: | SUITE 210 | ||||||||
| City: | TUCSON | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 857414529 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5204980082 | ||||||||
| FaxNumber: | 5204980210 | ||||||||
| Practice Location | |||||||||
| Address1: | 7225 N MONA LISA RD | ||||||||
| Address2: | SUITE 210 | ||||||||
| City: | TUCSON | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 857414529 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5204980082 | ||||||||
| FaxNumber: | 5204980210 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/17/2006 | ||||||||
| LastUpdateDate: | 05/14/2008 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 111N00000X | 7914 | AZ | Y | Chiropractic Providers | Chiropractor |
No ID Information.