Healthcare Provider Details

I. General information

NPI: 1366633935
Provider Name (Legal Business Name): ARROWHEAD HEALTH COACH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

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

III. Provider practice location address

7759 W BELL RD
PEORIA AZ
85382-5805
US

IV. Provider business mailing address

PO BOX 52457 DEPT #3002
PHOENIX AZ
85072-2457
US

V. Phone/Fax

Practice location:
  • Phone: 602-358-7429
  • Fax: 602-358-7434
Mailing address:
  • Phone: 602-358-7429
  • Fax: 602-358-7434

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number7478
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number7478
License Number StateAZ

VIII. Authorized Official

Name: JENNIFER A FRANKS-MITCHELL
Title or Position: DIRECTOR
Credential:
Phone: 602-358-7429