Arizona Chiropractic Society eNewsletter
Providing leadership, advocacy and resources that promote
professional excellence and quality patient care in chiropractic
Statewide Non-Profit
Chiropractic Association
Breaking News  July 24, 2008
ACS Launches Online
Find-A-Doc New Patient
Referral Search Engine

ACS has launched its online Find-A-Doc search engine for members. This is generating new patient referrals for members since the ACS webpage appears high on the list when Internet searches are done for Arizona chiropractors or chiropractic. It takes only one referral per year to cover the cost of annual dues. To join ACS and be listed on this highly valuable referral search engine, go to www.AZChiropractors.org and complete an application. ACS is ready to help you today!

Attention members: If you have not yet done so, send ACS a note stating that you would like to be listed on the Find-A-Doc search engine. Don't miss out on this valuable new patient opportunity! We have not yet heard from all of you. Send us a note today and get listed!
Special Thanks to Members of the ACS President's Club

Many thanks to our visionary members who contribute $279 per month to help ACS work hard for chiropractic progress. These doctors are premier members of the ACS President's Club. Special thanks to Drs. Rob van Zweeden, William Zeiler, Leo Rayburn, Trever Penny, Shaun and Nikki Miglore, E.J. Strandlund, Gregg Friedman, Angelo Pisano, Tracy Peruch, Jeff Raiffie, Randy Leraaen, Jeff Rebarcak, Josh and Jenna Haggard, and an anonymous DC. Please join these leaders today! ACS can do so much more for chiropractic with additional support!

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State Rep. Mark Anderson Orders
Formal Special Audit of
Arizona Chiropractic Board
 
Rep. Mark Anderson, at the request of ACS, has asked for a Formal Special Audit of the Arizona Chiropractic Board by the Arizona Auditor General. Audits are usually done every ten years and the next is not scheduled until 2011. Citing several "serious concerns," Rep. Anderson on 06/23/08 asked for an audit immediately. You can read his list of concerns and his entire letter posted on the ACS webpage at www.AZChiropractors.org. The allegations are:
  • Intimidation, humiliation, condescension, sarcasm, and unprofessional conduct directed at chiropractors who appear before the Board.
  • Enforcement of Recognized Standards of Care that do not exist.
  • Enforcing the laws unequally between chiropractors for the same violations.
  • Enforcement actions being taken for violations that are not written in statute or by rule. For example, requiring chiropractors to note time parameters and location of physiotherapy modalities when this is not required by rule or law.
  • Excessive reprimanding of chiropractors.
  • Failing to conform to the intent of the Chiropractic Act, i.e., imposing severe sanctions for minor record keeping violations when the chiropractor has done nothing to jeopardize the health, welfare, and safety of the patient or the public.
The allegations are the same as those made by ACS and an anonymous whistleblower to the Arizona Ombudsman-Citizens' Aide in 2006. ACS has stated that its allegations were largely ignored by the Ombudsman in a letter posted at www.AZChiropractors.org.
 
ACS President Dr. Alan M. Immerman issued the following statement on 6/24/08: "It is hard to understate the courage of Mark Anderson in ordering this audit. ACS asked other legislators for help and they all declined. Only Mark stood up for us, just as he has done throughout his 14 years of service at the Capitol. The Chiropractic Board has largely represented the entrenched interests of the insurance industry in wanting to reduce payments to chiropractors. An audit will uncover the sordid details. Mark is running for Congress in CD5 and is nonetheless willing to take on this political behemoth. He will pay a political price, but is fearless anyway. His integrity is a shining example for us all. Thank you, Mark from every chiropractor and chiropractic patient in Arizona. We will do everything we can to get you elected to the U.S. Congress."
ARIZONA
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SOCIETY
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3515 E. Carol Avenue
Phoenix, AZ 85028
VOICE 602.368.9496
FAX 602.368.8954

Board of Directors:
Alan M. Immerman, D.C.
Gregg Friedman, D.C.
Jenna Haggard, D.C.
Michael V. Giacoppo, D.C.
Kelly Buth, D.C.
Michael Cormier, D.C.
David Brotman, D.C.
Shaun Miglore, D.C.
Mark Klingert, D.C.
Clinton Bennion, D.C.
Erin Chisholm, D.C.
Bruce Homsey, D.C.

Lobbyist:
The Honorable
Debra Brimhall Pearson
 
ACS Lobbyist Debra Brimhall Pearson Resigns, New Veteran Lobbyist
Retained
 
It is with deep regret and sadness that ACS must report Debra Brimhall Pearson has resigned as the ACS lobbyist for personal reasons. ACS has hired veteran lobbyist Ed Wren. Ed has been a fixture at the Capitol for more than 25 years. He is recognized as an expert on health care matters since he also represents the entire faculty of the University of Arizona Medical College, organized as University Physicians. Ed also represents the law enforcement community and the hospitality industry. The chiropractic profession will be extremely well served by Mr.  Wren's competent and experienced representation.
ACS Launches Action for Enforcement
of Existing Insurance Equality Law

ACS is taking aggressive action on three fronts to enforce the existing insurance equality law. First, ACS has begun the process of taking legal action against ADOI to gain enforcement of the existing insurance equality law. As reported last month, ADOI has admitted that current law prohibits copayments and deductibles which discriminate against the usual and customary treatment procedures of chiropractors.  Now, all that is required is for ADOI to properly enforce the law. ACS intends to force ADOI to do so through legal measures. ACS needs the entire profession to support this legal effort for it to succeed.

In addition, ACS has worked closely with Senators Linda Gray and Rebecca Rios to research, draft and send a letter to state Attorney General Terry Goddard asking that his office enforce the insurance equality law. ACS lobbyist Debra Brimhall Pearson was charged with the task of getting dozens of signatures from other legislators for this letter. The draft letter is now posted on the ACS webpage.

The AAC has announced it is going to limit its effort to resolve the copay/deductible problem to another meeting with ADOI. The AAC does not plan to join the ACS legal action. Last year, ACS' attorney held a meeting with the ADOI Deputy Director and was told ADOI will not voluntarily change its interpretation of the insurance equality law. Therefore, ACS has scheduled no further meetings with ADOI. More meetings will only accomplish exactly what all of the past meetings have accomplished: absolutely nothing. Only legal action has any potential of gaining the needed result.

Finally, ACS has asked a number of individual legislators to intervene personally with the Governor and ADOI to try to resolve this problem. These efforts are ongoing at the present time.

ACS will stop at nothing to achieve true insurance equality for Arizona chiropractors. ACS has come to realize over the past months that it is not necessary to pass a new law, and that it is only necessary to enforce existing law. Legal action is required for enforcement, and so ACS will take such action, even though the AAC will not participate. ACS will safeguard and protect the Arizona chiropractic profession and form of healing, a tradition since 1991. ACS will not wait for anyone else to lead. If you are not already a member, join today and become part of the solution to your profession's problems.
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ACS Demands Halt to Chiropractic
Board's Fishing Expeditions

Only the Arizona Chiropractic Board conducts "fishing expeditions," not the Medical Board or the Osteopathic Board. A "fishing expedition" occurs when the Board receives a complaint about one limited matter, like fees, and uses it as a basis to "fish" around and examine your entire patient file, x-rays, clinical decision-making, etc.

If either the MD or DO Boards receive a fee complaint, they write back saying they have no jurisdiction and dismiss the complaint. But not the Chiropractic Board which, upon receipt of an obvious fee complaint, sends a subpoena for the entire patient file in order to launch what ACS has termed the now infamous Board "fishing expedition."

When you go fishing, you toss a line over the side of the boat to see what you might find. You know that if you fish long enough then you are likely to catch something! This is exactly what is done by the Arizona Chiropractic Board. They subpoena your entire file and then put it through the "screen", some of which you can read about on the Board's webpage. Does any DC survive the screen without some violation being found? ACS rarely hears of anyone so lucky.

Rarely, a doctor will get off with an hour of brow-beating. You have to attend a Board meeting yourself to believe it. Almost every DC has some deficiency in either record keeping, billing, coding, x-ray quality, clinical decision-making, etc. Almost every DC who started out with a fee complaint ends up with, at the very least, a non-disciplinary order for corrective CE courses in multiple areas.

In the eyes of the current Board members, almost all state DCs need substantial correction. Therefore, almost every innocuous fee complaint turns into corrective CE courses at a minimum. Many fee complaints result in actual disciplinary action. This scenario, of course, makes many DCs reluctant to press certain patients for collections due to concern that Board complaints may be generated.

ACS has long demanded that the Board handle fee complaints as fee complaints only. When ACS President Dr. Immerman met with Sen. Allen and Board Chair Dianne Haydon in December 2008 at the State Senate, Dr. Haydon stated that the Board simply had to subpoena the entire file to know for certain if the complaint "was only a fee complaint." Dr. Immerman stated that when a patient writes a complaint saying he is mad because the doctor did not refund, for example, $40, and that is the extent of the letter, it is obvious the complaint is limited to fees alone, and there is no need to subpoena the entire file. Dr. Haydon refused to budge and thus the status quo is maintained.

If you agree that the Board's position of expanding fee complaints into fishing expeditions is wrong, send letters to Governor Janet Napolitano at [email protected] and to the Governor's Secretary in charge of all Boards and Commissions, Dora Vasquez, at [email protected]. Also, if you do not want Dr. Steven Baker reappointed to the Board 07/01/09, send letters to both of these individuals stating why.
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DON'T MISS BREAKING NEWS -- SIGN UP FOR THE FREE ACS E-NEWSLETTER AT WWW.AZCHIROPRACTORS.ORG

CHECK THE FREQUENTLY UPDATED WEBSITE REGULARLY

Don't miss breaking news -- sign up for the free monthly ACS e-newsletter at www.AZChiropractors.org, and check the frequently updated website regularly. Go to the homepage at the upper left corner, enter your email address, and strike enter. Then you will be in the loop.

Also, ACS posts Arizona Chiropractic Board meeting minutes on the ACS Chiro Board webpage for all to see. Now you can finally learn what the Board is doing every month at its meetings. ACS wants the profession to see exactly how the Board is (mis)behaving.

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ACS Accomplishments

ACS advocacy has resulted in Rep. Mark Anderson, candidate for U.S. Congress in CD5, requesting a Special Formal Audit of the Arizona Chiropractic Board so that all dirty laundry will finally be aired. Mark has been ACS Legislator of the Year many times of his 14 year career at the Capitol.

ACS brought the issue of discriminatory copays and deductibles to the Arizona Legislature. Without ACS, there would have been no legislative effort to halt the discrimination. Also, ACS is the only organization planning legal action against ADOI to enforce existing insurance equality law.

ACS has confronted the Chiropractic Board over its gross mistreatment of state chiropractors. As a direct result, the Board has cleaned up some of its most egregious excesses. ACS joined in the successful 2007 Dr. Pratt lawsuit against the Board which led a judge to throw out almost all of the Board's discipline, and taught the Board a lesson well deserved about the consequences of unbridled power.

ACS passed a law in 2006 banning Chiropractic Board members from continuing to perform IMEs and claims reviews for insurance companies.

Because of ACS' intervention, CAs allowed to do more than just a few passive modalities. The CA rules were amended because of ACS to include the words "and is not limited to . . ." Without ACS, you would have been required to personally administer all active rehab.

ACS has a full-time veteran licensed DC at your service to answer all of your questions on any chiropractic issue. There is no claims denial problem we cannot address based on 28 years of experience in Arizona.
2008 Legislative Session Final Report

The 2008 Arizona legislative session is now adjourned. This is the final report from ACS about what occurred for the chiropractic profession.

Planning for the session began in the fall of 2007. As reported in the ACS newsletters, ACS attended a meeting in October of 2007 with the Chair of the House Health Committee, BCBS, AAC representatives, and other legislators. At this meeting, ACS announced its firm intention to move forward with legislation to lower copays and deductibles for chiropractic care. BCBS stated it would oppose this effort. The AAC stated it would maintain a neutral position, and that the copay bill was an ACS effort.

In January 2008, The ACS bill was introduced as SB 1152. ACS lobbyist Debra Brimhall Pearson, working alone, was successful in getting 46 of the 90 legislators to sign on as cosponsors. On 01/03/08, the AAC President sent an email to all AAC members stating that the AAC would not be supporting this legislation. The email, posted on the ACS webpage, stated: "We will not, however, embroil ourselves in the sometimes muddy complexities of the lawmaking process (and thereby tempt the law of unintended consequences) unless circumstances change appreciably." ACS was left to push for passage of the copay bill alone once again, a repeat of 2007.

The bill was heard in the Senate Health Committee but failed since opponents painted it as an effort to turn DCs into primary care physicians. ACS tried to revive the bill later in the House but failed to get the votes for the same reason. The bill would not have made DCs PCPs, but sometimes the facts do not matter in a political process.

Towards the end of the session, ACS asked a representative to run an amendment requiring non-discriminatory copays and deductibles. This proposed amendment was sent to ADOI which responded by saying such conduct is already illegal based on existing law. Therefore, following meetings with its expert attorneys, ACS decided to pursue enforcement of existing law rather than passing a new law which would, in the words of ADOI, only "repeat existing protections."

So this is where it stands today. ACS is in the early stages of taking legal action against ADOI to gain enforcement of existing law which ADOI has admitted in writing prohibits discriminatory copays and deductibles. AAC has declined to join the legal action and has announced that it will attack the problem with a meeting with ADOI. ACS exhausted the meeting route in 2007, and thus legal action is planned.

The other major event for chiropractic in 2008 was a non-event. There was no Mandate-Lite legislation. In 2007, such legislation was introduced. If passed, it would have eliminated chiropractic coverage in individual health insurance coverage. ACS worked for months in 2007 to kill this bill before it was born. Rep. Mark Anderson, a 14 year veteran at the Legislature and ACS' Legislator of the Year many times, led the effort behind the scenes to protect chiropractic from the dire effects of Mandate Lite. Mark is now running for Congress in CD 5. Every AZ chiropractor owes him a deep debt of gratitude. It would have been a disaster if chiropractic had been eliminated from individual health insurance in Arizona, a disaster narrowly averted by Mark Anderson, Debra Brimhall Pearson and ACS.
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Arizona Chiropractic Board Attacks
DC for Preaching Chiropractic

Read the Arizona Chiropractic Board minutes for May 8, 2008, Tab 08, posted at www.AZChiropractors.org. You will learn that it is now allegedly "false and misleading advertising" for a chiropractor to preach chiropractic.

What is the crime alleged to have been committed by your colleague David Stender, DC of Tucson? Here is what he posted in his office:

"When you have to wait for an adjustment and the office is packed, give a high five to your chiropractor and his team. The person you are waiting behind in the hot seats is getting off drugs, improving their lifestyle, correcting their spine, and moving toward God! When you wait, your community is getting better waiting, in this case, is good." "Opinions Change, But the Truth Remains."

The Board is planning to file charges against Dr. Stender for false and misleading advertising. In the minutes, they cite the above quote as the main example of his violations.

It is, apparently, no longer lawful for chiropractors to state that chiropractic relieves certain patients of the need to take certain drugs. The First Amendment to the U.S. Constitution allowing free speech no longer applies to DCs. If your methods are going to reduce pain and lead to reduced need for pain drugs, don't announce this fact or your license may be disciplined by the Chiropractic Board.

Thus is the state of affairs with Medipractors and Orthopedists Dianne Haydon and SteveBaker, and now, apparently, Susan Wenberg, at the helm of the Board. If you object to the current state of affairs, send letters to Governor Janet Napolitano at [email protected]. and Boards and Commissions Secretary Dora Vasquez at [email protected]. Ask them to remove these doctors and appoint some real chiropractors to the Board who will allow state DCs to practice chiropractic.

The AAC asked the Governor to appoint Drs. Haydon and Baker to the Board. The AAC recently asked the Governor to reappoint Dr. Haydon for a second five year term. The AAC refuses to support ACS' call for Haydon and Baker to resign or be removed. Haydon, Baker and Wenberg are all members of the AAC and  not ACS. All were among the less than 5% of the state DCs to attend the recent AAC annual convention. The AAC has its office across the hall from the Board. Former AAC President Wayne Bennett wrote a letter to the Governor asking that Dr. Baker be appointed to the Board. This letter is posted on the ACS webpage. The AAC blocked ACS's legislative effort with SB 1271 in 2008 in reign in the Board's ability to dictate clinical standards of practice. The AAC and the Arizona Chiropractic Board walk in lock step. They are one.

The ACS webpage is a history book for the profession in Arizona. ACS newsletters back to 1995 are posted. Read back at least to 2006 when ACS begain its campaign against the Board.  There has been considerable progress. Prior to June of 2006, the Board always disciplined licenses for record keeping and other minor violations. Now the Board almost never disciplines licenses for such violations, and instead issues non-disciplinary orders for CE courses. There is still a long way to go, and ACS is still hard at work. You should have great hope considering the huge improvements in just two years.
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The ACS Newsletter is the only publication in Arizona sent to every one of the approximately 2000 licensed chiropractors practicing in Arizona every month! Compare to the competition's journal which is mailed to 1250 every second month. This means 4000 exposures versus 1250 every two months - your choice - your results. Your notice of up to 70 words in print and online at www.AZChiropractors.org will get the best exposure and results available. Contact ACS at 602-368-9496 for rates and more information.
Arizona DC Dr. Mike Diehm
"Talks Back" to Chirostroke.com

Dear Chirostroke.com,
 
Was your guideline list commissioned to and constructed by a staff member's 8th grade son or daughter who found information on the first goggled website he came to?
 
My family, numerous friends and many, many acquaintances as well as myself have benefitted from chiropractic care for YEARS, and have thwarted the need for tens of thousands of dollars in crisis medical care because of it. The LEAST of the complaints, by the way, were musculoskeletal in nature, but rather include headache, asthma, ear infections, kidney, bladder, heart, female and blood pressure issues.
 
For me to recommend to anyone that they limit their chiropractic experience to backaches and leave the rest to the "real doctors" would be akin to recommending to a friend that they buy the latest state-of-the-art computer to play his music CD's on.
 
I understand chiropractic malpractice rates are STILL the lowest in the health-care industry. Heck, in this day and age, if you as much as scratch a patient with the edge of a poorly-groomed fingernail, liability insurance premiums will increase.

Please, please, please...use some informed intelligence when putting yourself in a position to inform the public. I mean, let's admit it: if chiropractic were causing as many strokes as you imply, the negative publicity alone would put the profession out of business overnight.
 
Regards,
 
Michael S. Diehm
[email protected]

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ACS New Member Benefits Package

ACS has a list of member benefits which we call the "Special Treasures" They are documents created by ACS just for Arizona chiropractors to address issues that arise in everyday practice. They are the answers to the most common problems faced in your office. The following is a current list:

1. Personalized advice on how to collect from insurance companies and attorneys after all of your usual methods have been tried and failed.
 
2. Dr. Preston Long rebuttal package, plus help with rebutting any unfair IME report.

3. Timely Payment of Claims, Adjudication and Adjustments: Complete instructions for exactly what to do when insurers do not pay in a timely manner.

4. Record Keeping as Mandated by the Chiropractic Board: ACS has nailed down the most accurate information in Arizona regarding what is required by the Board in terms of record keeping.

5. Medical Records Protocol: All chiropractors are required by law to have a proper Medical Records Protocol on file in their offices.

6. Health Care Appeals Process: THE system to follow in Arizona to get medical necessity denials overturned. ACS explains the complicated steps in easy terms so that you can use the program today in your office to increase collections.

7. Grievance Letters: These formal and legal letters are simply the best way to get an insurers' focused attention and to get your bills paid. ACS explains the entire Grievance process and shows you how to incorporate it into your practice.

8. Complete instructions for what to do when an insurer states that your fees are above the usual and customary fee schedule for your area.

9. Complete instructions for how to file a wide variety of complaints against any type of insurance company.

10. Personalized advice regarding whether you should join managed care networks including BCBS PPO, ACN, ASHN and many others.

11. Key ERISA self-funded plan tools.

12. Small Claims and Justice Court Lawsuit Instructions: Some offices have found that filing lawsuits on behalf of patients is an inexpensive an easy way to get your case in front of an impartial judge who will usually rule against an insurance company.

13. How to Search the National Library of Medicine.

14. Referrals to ACS' choice of an excellent attorney to represent Chiropractors before the Arizona Chiropractic Board.

15. Much more to come! Membership is very valuable! Join today by going to www.AZChiropractors.org and filling out an application. We will email you the above-listed documents very quickly! You can transform your practice almost overnight.

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INDEPENDENT CONTRACTOR opportunity at high volume well established Gilbert practice. Full or part time hours. Practice and personal growth coaching available! Call 480-497-2642.

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PRACTICE FOR SALE: low overhead, x-ray, 1K sq/ft, old patient files, equipment, DRX9000, 4 traction units, 2 IST tables, all starting @$1 check EBay. (520)449-3523 Dr. Watson, moving to new office.

NORTH SCOTTSDALE OFFICE FOR RENT: Troon North area at Pinnacle Peak. Space available in multidisciplinary setting for ambitious DC. Flexible terms, low base and/or % of collections. Beautifully furnished and equipped office. Call Alex at 602.549.2225 or e-mail to [email protected].

ELECTRIC ZENITH HI-LO FREE to good home. Has served me well for 28 years. Tom Stark, D.C. Tucson: 520-304-7474

NOVA SUMMIT XRAY MACHINE: Model #B360, made in 1996. Also: Konica Processor SRX 101, cassettes and film. Asking $6000 for all. May purchase individually. Call Dr. Cradic in Yuma at 928-344-2460.

CAS CHIRO NEEDS ASSOC DC to help in 3 locations:24thSt, 75thAve & Ch3.  Clinic does Chiro, Physiotherapy,Manual Therapy, Nutrition, DX Testing.  Will hire 1 F/T or 2 P/T.  Current AZ Chiro & PT Lic required. Fax to 602/956-6789 or email [email protected]

NE PHOENIX LOOKING FOR A LICENSED AZ CHIROPRACTOR highly motivated, self-starter wanting to share expenses/rent space in our beautiful 14 year established wellness, corrective care, family based practice. Call 602-363-2291. BG

"YOU-OWN A PROFITABLE CHIROPRACTIC OFFICE" Two positive cash flow offices avail. Right Now. Highly motivated sellers! Call Ron Marek 480-456-4700 Sunbelt Bus. Brokers. Web: http://buyphoenixbusiness.com. Email: [email protected].

PRACTICE FOR SALE: Well-established practice for sale in beautiful Flagstaff, Arizona. Reasonable rate. Doctor retiring and moving out of the country. Call Dr. David or Pamela Hopkins @ 928-774-2253.

ASSOCIATED NEEDED ASAP IN YUMA for busy clinic. AZ license and PT cert. required. Salary nego. with bonuses, malpractice ins. pd. Email resume to [email protected] or fax to (719) 574-7285.

BEAUTIFUL spacious NE PHX office @ 101/Tatum has space to share!  INCLUDES rehab, private rooms, x-ray, staff and billing. Contact Dr. Infantino @ 602-866-8100.

SCOTTSDALE/PHOENIX PRACTICE FOR SALE: 2007 collections 197K, 4 days/wk., great location and exposure for 20 yrs., hundreds of patient files, lots of parking. Retiring for family health reasons. Make offer, must sell. For further info, contact: [email protected] or 602-615-6751.

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2 ea.  WILLIAMS IST Table with Vibration. Color: Burgundy. $1,190.00
2 ea.  LLOYD Treatment Table. Color: Burgundy. $350.00
2 ea.  ZENITH 111 Model 230 Hi/Low Table with 3 drops all standard features, 6 months old. Color: Black. $7,084.00
1 ea.  ZENITH Model 60 Stationary Table with 3 drops all standard features, 6 months old. Color: Black. $4,025.00
2 ea.  ZENITH SPINALIGN IST Table with vibration, 6 months old. Color: Burgundy. $1,650.00
3 ea.  ELITE Manual Flexion with 3drops. Color: 2-Blue, 1-Burgundy New. $1,920.00
1 ea. CHATTANOOGA ERGO WAVE IST 6 months old. Color: Burgundy. $1,327.00
1ea.  CHATTANOOGA ERGO Bench Table with tilt head piece, New. Color: Black. $780.00
1ea.  EARTHLITE Bench Table with tilt head piece, New. Color: Black. $780.00
2 ea. ZENITH 4 CHANNEL MUSCLE STIM $ 2,000.00
2 ea. ZENITH MULTISTIM COMBO $ 2,200.00
CUSTOM X-RAY EQUIPMENT SALES & SERVICE~2120 W. ENCANTO BLVD, PHOENIX, AZ 85009    www.customxray.com    602-439-3100    800-230-9726

YOUR AD HERE: 3 lines, $25 per month for members, $50 per month for non-members. Monthly newsletter mailed to average circulation of 2000 licensed DCs in Arizona. Also emailed and posted online. Compare to competition's journal which is mailed to 1250 every second month. 4000 exposures versus 1250 every two months - your choice - your results.