Provider Demographics
NPI:1437306255
Name:HEALTHWISE WELLNESS CENTERS LLC
Entity Type:Organization
Organization Name:HEALTHWISE WELLNESS CENTERS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:HOTCHKISS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-390-9555
Mailing Address - Street 1:PO BOX 22109
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85277-2109
Mailing Address - Country:US
Mailing Address - Phone:480-390-9555
Mailing Address - Fax:
Practice Address - Street 1:6840 E BROWN RD
Practice Address - Street 2:SUITE 104
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85207-3759
Practice Address - Country:US
Practice Address - Phone:480-390-9555
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-22
Last Update Date:2008-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy