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General NPI Number Information
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NPI Number | 1104476993
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Entity Type | Organization
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Legal Business Name | RENEW WELLNESS
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Dates
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Enumeration Date | 09/13/2019
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Last Update Date | 01/13/2026
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Provider Practice Location Address
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Address Line | 3303 E BASELINE RD STE 204
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City | GILBERT
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State | AZ
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Zip | 85234-2728
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Country | US
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Telephone | 480-630-1733
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Fax | 480-304-3297
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Provider Business Mailing Address
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Address Line | 3303 E BASELINE RD STE 204
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City | GILBERT
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State | AZ
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Zip | 85234-2728
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Country | US
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Telephone | 480-630-1733
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Fax | 480-304-3297
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Authorized Official
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Title or Position | OWNER
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Name | KAMEE WITTS
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Credential | NP
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Telephone | 480-276-1802
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QI0500X
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Taxonomy Name | Infusion Therapy Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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