Provider Demographics
NPI:1013188770
Name:CALVO NATUROPATHIC HEALTHCARE
Entity Type:Organization
Organization Name:CALVO NATUROPATHIC HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, NATUROPATHIC MEDICAL DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:A
Authorized Official - Last Name:GENTRY
Authorized Official - Suffix:
Authorized Official - Credentials:NMD
Authorized Official - Phone:623-251-5518
Mailing Address - Street 1:42104 N VENTURE DR
Mailing Address - Street 2:STE. C-126
Mailing Address - City:ANTHEM
Mailing Address - State:AZ
Mailing Address - Zip Code:85086-3823
Mailing Address - Country:US
Mailing Address - Phone:623-251-5518
Mailing Address - Fax:623-249-4748
Practice Address - Street 1:42104 N VENTURE DR
Practice Address - Street 2:STEC126
Practice Address - City:ANTHEM
Practice Address - State:AZ
Practice Address - Zip Code:85086-3823
Practice Address - Country:US
Practice Address - Phone:623-251-5518
Practice Address - Fax:623-249-4748
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-20
Last Update Date:2011-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ06-916261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care