Provider Demographics
NPI:1134460553
Name:WHOLE HEALTH CENTER SOUTHWEST, LLC
Entity Type:Organization
Organization Name:WHOLE HEALTH CENTER SOUTHWEST, LLC
Other - Org Name:WHOLE HEALTH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROD
Authorized Official - Middle Name:
Authorized Official - Last Name:VALDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:CMT
Authorized Official - Phone:303-910-4580
Mailing Address - Street 1:4260 S WADSWORTH BLVD
Mailing Address - Street 2:SUITE 150
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80123-1346
Mailing Address - Country:US
Mailing Address - Phone:303-910-4580
Mailing Address - Fax:303-989-0640
Practice Address - Street 1:4260 S WADSWORTH BLVD
Practice Address - Street 2:SUITE 150
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80123-1346
Practice Address - Country:US
Practice Address - Phone:303-910-4580
Practice Address - Fax:303-989-0640
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-11
Last Update Date:2013-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0014529172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172M00000XOther Service ProvidersMechanotherapistGroup - Multi-Specialty