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General NPI Number Information
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NPI Number | 1003450461
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Entity Type | Organization
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Legal Business Name | STILLPOINT WELLNESS, LLC
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Dates
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Enumeration Date | 10/29/2019
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Last Update Date | 10/29/2019
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Provider Practice Location Address
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Address Line | 2266 S DOBSON RD STE 200
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City | MESA
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State | AZ
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Zip | 85202-6412
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Country | US
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Telephone | 480-280-1996
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Fax | 602-532-7649
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Provider Business Mailing Address
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Address Line | PO BOX 43225
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City | PHOENIX
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State | AZ
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Zip | 85080-3225
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. EARL KIMBELL III
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Credential | DO
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Telephone | 602-821-6850
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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