Healthcare Provider Details

I. General information

NPI: 1225944945
Provider Name (Legal Business Name): FRONTIER WELLNESS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/21/2026
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1890 COMMANDER DR STE 100
LAKE HAVASU CITY AZ
86403-3226
US

IV. Provider business mailing address

4539 N 22ND ST STE 8293
PHOENIX AZ
85016-4639
US

V. Phone/Fax

Practice location:
  • Phone: 866-706-6664
  • Fax: 855-275-8438
Mailing address:
  • Phone: 866-706-6664
  • Fax: 855-275-8438

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State

VIII. Authorized Official

Name: STEPHANIE CREWS
Title or Position: MANAGING MEMBER
Credential:
Phone: 866-706-6664