Provider Demographics
NPI:1689844623
Name:SIGNATURE CHIROPRACTIC, LTD
Entity type:Organization
Organization Name:SIGNATURE CHIROPRACTIC, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ALBERT
Authorized Official - Middle Name:NAHYUN
Authorized Official - Last Name:KIM
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:623-334-4114
Mailing Address - Street 1:8345 W THUNDERBIRD RD
Mailing Address - Street 2:#B103
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85381-3668
Mailing Address - Country:US
Mailing Address - Phone:623-334-4114
Mailing Address - Fax:623-334-4117
Practice Address - Street 1:8345 W THUNDERBIRD RD
Practice Address - Street 2:#B103
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85381-3668
Practice Address - Country:US
Practice Address - Phone:623-334-4114
Practice Address - Fax:623-334-4117
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-05
Last Update Date:2009-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7560111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty