Provider Demographics
NPI:1558747626
Name:URBAN WELLNESS AND BOTANICALS, LLC
Entity Type:Organization
Organization Name:URBAN WELLNESS AND BOTANICALS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALEXIS
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:SHOWERS
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:480-446-3333
Mailing Address - Street 1:1801 S JENTILLY LN
Mailing Address - Street 2:STE B 10
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85281-5758
Mailing Address - Country:US
Mailing Address - Phone:480-446-3333
Mailing Address - Fax:
Practice Address - Street 1:1801 S JENTILLY LN
Practice Address - Street 2:STE B 10
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85281-5758
Practice Address - Country:US
Practice Address - Phone:480-446-3333
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-30
Last Update Date:2015-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZMT-17103225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty