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General NPI Number Information
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NPI Number | 1629238589
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Entity Type | Organization
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Legal Business Name | WORLD INTEGRATED SYSTEMS IN HEALTH, LLC
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Dates
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Enumeration Date | 06/13/2008
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Last Update Date | 06/13/2008
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Provider Practice Location Address
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Address Line | 4627 N 1ST AVE SUITE #2
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City | TUCSON
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State | AZ
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Zip | 85718-8606
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Country | US
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Telephone | 520-743-0575
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Fax |
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Provider Business Mailing Address
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Address Line | 4627 N 1ST AVE SUITE #2
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City | TUCSON
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State | AZ
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Zip | 85718-8606
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Country | US
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Telephone | 520-743-0575
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. SANDRA J. BEVACQUA
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Credential | PH.D.
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Telephone | 520-743-0575
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133NN1002X
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Taxonomy Name | Nutrition Education Nutritionist
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License Number |
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License Number State | AZ
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