Healthcare Provider Details

I. General information

NPI: 1467658955
Provider Name (Legal Business Name): DANIELA HUTYROVA NMD, PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/22/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

203 S CANDY LN SUITE 2B
COTTONWOOD AZ
86326-4120
US

IV. Provider business mailing address

203 S CANDY LN SUITE 2B
COTTONWOOD AZ
86326-4120
US

V. Phone/Fax

Practice location:
  • Phone: 928-649-9686
  • Fax: 928-649-2024
Mailing address:
  • Phone: 928-649-9686
  • Fax: 928-649-2024

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number98-542
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: