Provider Demographics
NPI:1033505482
Name:HERITAGE OF HEALTH, PLLC
Entity Type:Organization
Organization Name:HERITAGE OF HEALTH, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:R
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-729-9589
Mailing Address - Street 1:2402 E 5TH ST
Mailing Address - Street 2:#1429
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85281-3390
Mailing Address - Country:US
Mailing Address - Phone:480-729-9589
Mailing Address - Fax:
Practice Address - Street 1:16700 N THOMPSON PEAK PKWY
Practice Address - Street 2:SUITE #260
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-2384
Practice Address - Country:US
Practice Address - Phone:480-991-5555
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-13
Last Update Date:2015-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAZ 12-1322175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175F00000XOther Service ProvidersNaturopathGroup - Single Specialty