Healthcare Provider Details

I. General information

NPI: 1902612062
Provider Name (Legal Business Name): RYCO WELLNESS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/04/2024
Last Update Date: 04/08/2025
Certification Date: 04/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21803 N SCOTTSDALE RD STE 200
SCOTTSDALE AZ
85255-7446
US

IV. Provider business mailing address

35628 N 7TH AVE
PHOENIX AZ
85086-7208
US

V. Phone/Fax

Practice location:
  • Phone: 602-805-2220
  • Fax: 602-807-4323
Mailing address:
  • Phone: 602-805-2220
  • Fax: 602-807-4323

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: KENDRA CARTER
Title or Position: OWNER/NURSE PRACTITIONER
Credential: FNP-BC
Phone: 602-826-0805