MEDICARE: BIOWELL P.C.

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	174400000X	Specialist

General Provider Information

NPI Number	:	1689050718
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BIOWELL P.C.

Provider Business Mailing Address
First Line	:	8900 E PINNACLE PEAK RD STE E200
Second Line	:
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85255-3668
Country	:	US
Telephone Number	:	844-650-5908
Fax Number	:

Provider Business Practice Location Address
First Line	:	16427 N SCOTTSDALE RD STE 410
Second Line	:
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85254-7102
Country	:	US
Telephone Number	:	844-650-5908
Fax Number	:

Authorized Official
Title or Position	:	PRINCIPAL
Name	:	DR. THOMAS GARRISON
Credential	:	M.D.
Telephone Number	:	801-721-1111

Provider Enumeration Date	:	07/30/2015
Last Update Date	:	07/30/2015

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