=====================================================
General NPI Number Information
=====================================================
NPI Number | 1609166594
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | BEGIN WITHIN WELLNESS CORP
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/12/2011
-----------------------------------------------------
Last Update Date | 05/31/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 7120 E INDIAN SCHOOL RD STE B
-----------------------------------------------------
City | SCOTTSDALE
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85251-3855
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 480-699-3086
-----------------------------------------------------
Fax | 480-699-2649
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 7120 E INDIAN SCHOOL RD STE B
-----------------------------------------------------
City | SCOTTSDALE
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85251-3855
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 480-699-3086
-----------------------------------------------------
Fax | 480-699-2649
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | DR. KYLE M COLLINS
-----------------------------------------------------
Credential | D.C
-----------------------------------------------------
Telephone | 480-699-3086
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number | 8182
-----------------------------------------------------
License Number State | AZ
-----------------------------------------------------