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General NPI Number Information
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NPI Number | 1720482888
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Entity Type | Organization
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Legal Business Name | SVELTE LLC
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Dates
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Enumeration Date | 10/20/2014
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Last Update Date | 01/04/2016
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Provider Practice Location Address
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Address Line | 17787 N PERIMETER DR STE A107
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City | SCOTTSDALE
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State | AZ
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Zip | 85255-5454
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Country | US
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Telephone | 480-203-2535
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Fax |
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Provider Business Mailing Address
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Address Line | 17787 N PERIMETER DR STE A107
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City | SCOTTSDALE
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State | AZ
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Zip | 85255-5454
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Country | US
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Telephone | 480-203-2535
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | TRACY VARLEY NYMEYER
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Credential |
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Telephone | 505-400-3889
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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