MEDICARE: BODISENSE INTEGRATIVE MEDICINE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	175F00000X	Naturopath	141450	AZ

General Provider Information

NPI Number	:	1619370285
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BODISENSE INTEGRATIVE MEDICINE

Provider Business Mailing Address
First Line	:	PO BOX 14243
Second Line	:
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85267-4243
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4657 S LAKESHORE DR
Second Line	:	SUITE 1
City	:	TEMPE
State	:	AZ
Zip	:	85282-7170
Country	:	US
Telephone Number	:	480-284-8155
Fax Number	:	866-823-2115

Authorized Official
Title or Position	:	OWNER
Name	:	DR. ALEXANDRA MAYER
Credential	:	N.D
Telephone Number	:	480-789-2746

Provider Enumeration Date	:	09/26/2014
Last Update Date	:	09/26/2014

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