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NPI Code Detail

MEDICARE: CHAMBO WELLNESS CENTER, LLC

MEDICARE: CHAMBO WELLNESS CENTER, LLC
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
1208100000XPhysical Medicine & Rehabilitation PhysicianAZ

General Provider Information

NPI Number : 1699903872
Entity Type Code : Organization
Provider Name (Legal Business Name) : CHAMBO WELLNESS CENTER, LLC
Provider Business Mailing Address
First Line : 4925 W BELL RD
Second Line : SUITE C-7
City : GLENDALE
State : AZ
Zip : 85308-3427
Country : US
Telephone Number : 602-789-6753
Fax Number :
Provider Business Practice Location Address
First Line : 4925 W BELL RD
Second Line : SUITE C-7
City : GLENDALE
State : AZ
Zip : 85308-3427
Country : US
Telephone Number : 602-789-6753
Fax Number :
Authorized Official
Title or Position : OWNER
Name : TODD CHAMBERS
Credential :
Telephone Number : 623-694-0987
Provider Enumeration Date : 06/26/2009
Last Update Date : 06/26/2009

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Directions to “CHAMBO WELLNESS CENTER, LLC ” Practice Location

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