VALLEY INTEGRATED WELLNESS LLC NPI 1477920064

NPI Information

VALLEY INTEGRATED WELLNESS LLC is a family nurse practitioner in Peoria, AZ. VALLEY INTEGRATED WELLNESS LLC NPI is 1477920064. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

21585 N. 77TH AVENUE
SUITE 1500
PEORIA, AZ
ZIP 85382
Phone: (623) 476-5227
Fax: (623) 476-8379

The provider's authorized official is Sandra L. Decarlo .
The authorized official title is Owner and has the following contact phone number (623) 476-5227.

The CLIA number assigned to this NPI record is 03D2100784 - community clinic with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/31/2015 and was last updated on 10/12/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

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