Healthcare Provider Details

I. General information

NPI: 1508793662
Provider Name (Legal Business Name): HILL FUCNCTIONAL WELLNESS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/05/2026
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2143 E SOUTHERN AVE
TEMPE AZ
85282-7533
US

IV. Provider business mailing address

2143 E SOUTHERN AVE
TEMPE AZ
85282-7533
US

V. Phone/Fax

Practice location:
  • Phone: 480-897-1788
  • Fax: 480-897-0076
Mailing address:
  • Phone: 480-897-1788
  • Fax: 480-897-0076

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code111NN1001X
TaxonomyNutrition Chiropractor
License Number
License Number State

VIII. Authorized Official

Name: STEPHEN BRADLEY HILL
Title or Position: CEO
Credential: DC
Phone: 480-235-5014