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General NPI Number Information
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NPI Number | 1508553231
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Entity Type | Organization
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Legal Business Name | CHOOSE LIFE WELLNESS
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Dates
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Enumeration Date | 04/21/2023
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Last Update Date | 04/21/2023
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Provider Practice Location Address
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Address Line | 8385 N 7TH ST
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City | PHOENIX
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State | AZ
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Zip | 85020-3440
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Country | US
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Telephone | 480-228-7800
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 50481
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City | PHOENIX
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State | AZ
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Zip | 85076-0481
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Country | US
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Telephone | 480-228-7800
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Fax |
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | ANGELA CROWDER
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Credential |
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Telephone | 480-228-7800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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