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General NPI Number Information
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NPI Number | 1538985460
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Entity Type | Organization
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Legal Business Name | SUN VALLEY HEALTH & WELLNESS LLC
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Dates
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Enumeration Date | 11/25/2024
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Last Update Date | 02/26/2025
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Provider Practice Location Address
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Address Line | 12361 W BOLA DR STE 107
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City | SURPRISE
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State | AZ
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Zip | 85378-9021
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Country | US
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Telephone | 623-266-1333
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Fax | 602-773-5674
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Provider Business Mailing Address
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Address Line | 12361 W BOLA DR STE 107
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City | SURPRISE
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State | AZ
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Zip | 85378-9021
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Country | US
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Telephone | 623-266-1333
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Fax | 602-773-5674
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Authorized Official
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Title or Position | MEMBER
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Name | PATRICIA POLSON
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Credential | NP
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Telephone | 602-721-9787
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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 |
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License Number State |
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