Healthcare Provider Details

I. General information

NPI: 1003358607
Provider Name (Legal Business Name): ARIS HEALTH CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/14/2016
Last Update Date: 11/14/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17100 N 67TH AVE BLDG 1
GLENDALE AZ
85308-3605
US

IV. Provider business mailing address

17100 N 67TH AVE BLDG 1
GLENDALE AZ
85308-3605
US

V. Phone/Fax

Practice location:
  • Phone: 623-979-2747
  • Fax: 623-979-3122
Mailing address:
  • Phone: 623-979-2747
  • Fax: 623-979-3122

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License NumberOTC4195
License Number StateAZ

VIII. Authorized Official

Name: PAULINE HERNANDEZ
Title or Position: BUSINESS OFFICE MANAGER
Credential:
Phone: 623-979-2747