Healthcare Provider Details

I. General information

NPI: 1588114151
Provider Name (Legal Business Name): HEART 2 HEART RADIAN REFLEXIONS WELLNESS & AESTHETICS CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/07/2016
Last Update Date: 10/07/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2451 E BASELINE RD STE 310
GILBERT AZ
85234-2471
US

IV. Provider business mailing address

2451 E BASELINE RD STE 310
GILBERT AZ
85234-2471
US

V. Phone/Fax

Practice location:
  • Phone: 602-309-2678
  • Fax:
Mailing address:
  • Phone: 602-309-2678
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code173C00000X
TaxonomyReflexologist
License Number
License Number State

VIII. Authorized Official

Name: MRS. LORETTA ANN RODGERS
Title or Position: OWNER/OPERATOR
Credential: LMT
Phone: 602-309-2678