Healthcare Provider Details
I. General information
NPI: 1164172425
Provider Name (Legal Business Name): FUSION HEALTHWAYS LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/28/2022
Last Update Date: 03/28/2022
Certification Date: 03/28/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1957 E AZALEA CT
GILBERT AZ
85298-3232
US
IV. Provider business mailing address
1957 E AZALEA CT
GILBERT AZ
85298-3232
US
V. Phone/Fax
- Phone: 480-771-5222
- Fax:
- Phone: 480-771-5222
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261Q00000X |
| Taxonomy | Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ROLLIN
J
WEBB
Title or Position: CEO/FOUNDER
Credential:
Phone: 480-771-5222