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General NPI Number Information
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NPI Number | 1508301813
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Entity Type | Organization
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Legal Business Name | TRAVEL VACCINES & WELLNESS SOLUTIONS
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Dates
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Enumeration Date | 12/21/2016
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Last Update Date | 12/21/2016
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Provider Practice Location Address
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Address Line | 2421 E SOUTHERN AVE SUITE 5
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City | TEMPE
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State | AZ
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Zip | 85282-7612
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Country | US
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Telephone | 480-462-0188
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Fax |
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Provider Business Mailing Address
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Address Line | 2421 E SOUTHERN AVE SUITE 5
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City | TEMPE
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State | AZ
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Zip | 85282-7612
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Country | US
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Telephone | 480-462-0188
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | ERIN FRY
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Credential |
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Telephone | 480-462-0188
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 33212
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License Number State | AZ
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