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General NPI Number Information
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NPI Number | 1083923338
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Entity Type | Organization
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Legal Business Name | WESTMISTER VILLAGE WELLNESS CENTER
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Dates
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Enumeration Date | 10/05/2010
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Last Update Date | 10/05/2010
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Provider Practice Location Address
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Address Line | 12000 N 90TH ST
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City | SCOTTSDALE
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State | AZ
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Zip | 85260-8604
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Country | US
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Telephone | 480-451-2000
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Fax | 480-451-2154
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Provider Business Mailing Address
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Address Line | 12000 N 90TH ST
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City | SCOTTSDALE
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State | AZ
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Zip | 85260-8604
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Country | US
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Telephone | 480-451-2000
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Fax | 480-451-2154
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Authorized Official
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Title or Position | C.E.O.
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Name | MR. LEWIS HART
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Credential |
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Telephone | 480-451-2000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | OTC4826
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License Number State | AZ
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