Organization Name: | ARIZONA PROACTIVE HEALTH AND MEDICINE |
NPI Number: | 1447673868 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | SEVOY FILLERUP (CHEIF MEDICAL OFFICER) |
Mailing Address: | 81 W Guadalupe Rd Gilbert |
State: | AZ US |
Postal Code: | 852333321 |
Phone Number: | 4803664496 |
Fax Number: | 8004480729 |
NPI Enumeration Date: | 01/22/2014 |
NPI Last Update Date: | 02/21/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | P18967986 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | AZ |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |