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General NPI Number Information
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NPI Number | 1811756091
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Entity Type | Organization
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Legal Business Name | ENLIGHTENED WAY HEALTH LLC
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Dates
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Enumeration Date | 03/18/2024
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Last Update Date | 03/18/2024
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Provider Practice Location Address
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Address Line | 10730 N ORACLE RD UNIT 25104
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City | ORO VALLEY
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State | AZ
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Zip | 85737-9419
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Country | US
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Telephone | 317-850-7302
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Fax |
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Provider Business Mailing Address
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Address Line | 10730 N ORACLE RD UNIT 25104
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City | ORO VALLEY
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State | AZ
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Zip | 85737-9419
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Country | US
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Telephone | 317-850-7302
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CORA LYNN TOMPKINS
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Credential | MD
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Telephone | 317-850-7302
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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