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General NPI Number Information
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NPI Number | 1710614128
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Entity Type | Organization
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Legal Business Name | PREFERRED VERVE LLC
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Dates
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Enumeration Date | 08/05/2022
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Last Update Date | 08/05/2022
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Provider Practice Location Address
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Address Line | 3341 E QUEEN CREEK RD STE 109
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City | GILBERT
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State | AZ
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Zip | 85297-8510
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Country | US
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Telephone | 480-582-3210
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Fax | 480-436-6571
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Provider Business Mailing Address
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Address Line | 4838 E BASELINE RD STE 110
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City | MESA
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State | AZ
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Zip | 85206-4674
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Country | US
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Telephone | 480-582-3210
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Fax | 480-436-6571
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Authorized Official
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Title or Position | AUTHORIZED CONTACT
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Name | MS. BETHANY S WRIGHT
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Credential |
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Telephone | 310-770-6368
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 175F00000X
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Taxonomy Name | Naturopath
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License Number |
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License Number State |
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Taxonomy #3
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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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Taxonomy #4
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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 |
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Taxonomy #5
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 202D00000X
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Taxonomy Name | Integrative Medicine Physician
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License Number |
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License Number State |
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