Healthcare Provider Details

I. General information

NPI: 1851147151
Provider Name (Legal Business Name): WELLNESS READY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/26/2024
Last Update Date: 07/29/2024
Certification Date: 07/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

60 E RIO SALADO PKWY STE 900
TEMPE AZ
85281-9126
US

IV. Provider business mailing address

8435 E BASELINE RD STE 109
MESA AZ
85209-4382
US

V. Phone/Fax

Practice location:
  • Phone: 928-550-2973
  • Fax:
Mailing address:
  • Phone: 928-550-2973
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: GABRIEL BUENO CARO
Title or Position: CEO
Credential:
Phone: 928-550-2973