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General NPI Number Information
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NPI Number | 1134805021
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Entity Type | Organization
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Legal Business Name | NATURE HEALTH CLINICS OF ARIZONA
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Dates
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Enumeration Date | 06/26/2023
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Last Update Date | 06/26/2023
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Provider Practice Location Address
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Address Line | 3909 N. 16 STREET
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City | PHOENIX
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State | AZ
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Zip | 85016
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Country | US
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Telephone | 480-410-7625
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Fax | 602-864-9161
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Provider Business Mailing Address
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Address Line | 3909 N. 16 STREET
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City | PHOENIX
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State | AZ
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Zip | 85016
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Country | US
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Telephone | 480-410-7625
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Fax | 602-864-9161
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Authorized Official
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Title or Position | PARTNER
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Name | DR. GORDON DONALD GROSS
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Credential | DDS
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Telephone | 480-410-7625
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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