MEDICARE: CHOICES INTEGRATIVE HEALTH CARE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	27754	AZ

General Provider Information

NPI Number	:	1801836689
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHOICES INTEGRATIVE HEALTH CARE

Provider Business Mailing Address
First Line	:	95 SOLDIERS PASS RD
Second Line	:	SUITE B
City	:	SEDONA
State	:	AZ
Zip	:	86336-4781
Country	:	US
Telephone Number	:	928-203-4863
Fax Number	:	928-203-4497

Provider Business Practice Location Address
First Line	:	95 SOLDIERS PASS RD
Second Line	:	SUITE B
City	:	SEDONA
State	:	AZ
Zip	:	86336-4781
Country	:	US
Telephone Number	:	928-203-4863
Fax Number	:	928-203-4497

Authorized Official
Title or Position	:	OWNER / PHYSICIAN
Name	:	DR. DEVIN A MIKLES
Credential	:	MD
Telephone Number	:	928-203-4844

Provider Enumeration Date	:	06/08/2006
Last Update Date	:	06/19/2012

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