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General NPI Number Information
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NPI Number | 1215022801
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Entity Type | Organization
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Legal Business Name | BALANCED HEALTH AND WELLNESS P.L.C.
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Dates
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Enumeration Date | 10/03/2006
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Last Update Date | 02/01/2008
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Provider Practice Location Address
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Address Line | 6226 E. PIMA ST. SUITE 3
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City | TUCSON
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State | AZ
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Zip | 85712
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Country | US
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Telephone | 520-323-1600
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Fax |
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Provider Business Mailing Address
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Address Line | 6226 E. PIMA ST. SUITE 3
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City | TUCSON
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State | AZ
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Zip | 85712
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Country | US
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Telephone | 520-323-1600
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. GENIFER Y CHAVEZ
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Credential | M.D.
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Telephone | 520-323-1600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 16259
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License Number State | AZ
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