Basic Information
| Provider Information | |||||||||
| NPI: | 1013182856 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WAYCHOFF | ||||||||
| FirstName: | ERIN | ||||||||
| MiddleName: | LEE | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | D.C. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 2954 | ||||||||
| Address2: | |||||||||
| City: | PHOENIX | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 850622954 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6028895833 | ||||||||
| FaxNumber: | 6028895834 | ||||||||
| Practice Location | |||||||||
| Address1: | 3202 E GREENWAY RD | ||||||||
| Address2: | #1619 | ||||||||
| City: | PHOENIX | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 850324548 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6022848994 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/23/2008 | ||||||||
| LastUpdateDate: | 06/23/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 111N00000X | 7926 | AZ | Y | Chiropractic Providers | Chiropractor |
No ID Information.