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General NPI Number Information
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NPI Number | 1134460553
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Entity Type | Organization
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Legal Business Name | WHOLE HEALTH CENTER SOUTHWEST, LLC
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Dates
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Enumeration Date | 03/11/2013
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Last Update Date | 03/11/2013
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Provider Practice Location Address
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Address Line | 4260 S WADSWORTH BLVD SUITE 150
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City | LITTLETON
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State | CO
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Zip | 80123-1346
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Country | US
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Telephone | 303-910-4580
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Fax | 303-989-0640
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Provider Business Mailing Address
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Address Line | 4260 S WADSWORTH BLVD SUITE 150
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City | LITTLETON
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State | CO
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Zip | 80123-1346
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Country | US
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Telephone | 303-910-4580
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Fax | 303-989-0640
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Authorized Official
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Title or Position | OWNER
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Name | ROD VALDEZ
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Credential | CMT
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Telephone | 303-910-4580
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 172M00000X
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Taxonomy Name | Mechanotherapist
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License Number | 0014529
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License Number State | CO
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