Healthcare Provider Details

I. General information

NPI: 1457591612
Provider Name (Legal Business Name): NATURAL WELLNESS CARE CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/02/2009
Last Update Date: 03/02/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7558 W THUNDERBIRD RD SUITE 4B
PEORIA AZ
85381-6080
US

IV. Provider business mailing address

7558 W THUNDERBIRD RD SUITE 4B
PEORIA AZ
85381-6080
US

V. Phone/Fax

Practice location:
  • Phone: 623-412-2241
  • Fax: 623-412-2251
Mailing address:
  • Phone: 623-412-2241
  • Fax: 623-412-2251

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number1046
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number1614
License Number StateAZ

VIII. Authorized Official

Name: DR. HECTOR A VARELA
Title or Position: OWNER
Credential: D.C.
Phone: 623-412-2241