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General NPI Number Information
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NPI Number | 1699903872
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Entity Type | Organization
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Legal Business Name | CHAMBO WELLNESS CENTER, LLC
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Dates
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Enumeration Date | 06/26/2009
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Last Update Date | 06/26/2009
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Provider Practice Location Address
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Address Line | 4925 W BELL RD SUITE C-7
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City | GLENDALE
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State | AZ
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Zip | 85308-3427
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Country | US
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Telephone | 602-789-6753
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Fax |
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Provider Business Mailing Address
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Address Line | 4925 W BELL RD SUITE C-7
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City | GLENDALE
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State | AZ
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Zip | 85308-3427
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Country | US
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Telephone | 602-789-6753
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | TODD CHAMBERS
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Credential |
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Telephone | 623-694-0987
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number |
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License Number State | AZ
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