Provider Demographics
NPI:1225620271
Name:AT THE MOMENT HEALTH, LLC
Entity Type:Organization
Organization Name:AT THE MOMENT HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BRADFORD
Authorized Official - Suffix:
Authorized Official - Credentials:ND
Authorized Official - Phone:480-251-6215
Mailing Address - Street 1:1959 S POWER RD STE 103
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85206-4398
Mailing Address - Country:US
Mailing Address - Phone:480-228-6119
Mailing Address - Fax:
Practice Address - Street 1:7552 E DRUMMER AVE
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85208-2041
Practice Address - Country:US
Practice Address - Phone:480-228-6119
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-10
Last Update Date:2021-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175F00000XOther Service ProvidersNaturopathGroup - Multi-Specialty