Healthcare Provider Details

I. General information

NPI: 1194428441
Provider Name (Legal Business Name): AXON INTEGRATIVE HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/24/2023
Last Update Date: 03/24/2023
Certification Date: 03/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1720 S BELLAIRE ST STE 801
DENVER CO
80222-4331
US

IV. Provider business mailing address

1720 S BELLAIRE ST STE 801
DENVER CO
80222-4331
US

V. Phone/Fax

Practice location:
  • Phone: 720-994-2966
  • Fax:
Mailing address:
  • Phone: 720-994-2966
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code202D00000X
TaxonomyIntegrative Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code111NN0400X
TaxonomyNeurology Chiropractor
License Number
License Number State

VIII. Authorized Official

Name: DR. HANA WADSWORTH
Title or Position: OWNER/PHYSICIAN
Credential: DC
Phone: 850-758-1687