Provider Demographics
NPI:1588183420
Name:HOLISTIC HEALING AND WELLNESS CENTER, P.C.
Entity Type:Organization
Organization Name:HOLISTIC HEALING AND WELLNESS CENTER, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JAY
Authorized Official - Middle Name:DANIEL
Authorized Official - Last Name:ZAMORA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:520-364-6463
Mailing Address - Street 1:1915 E 10TH ST
Mailing Address - Street 2:
Mailing Address - City:DOUGLAS
Mailing Address - State:AZ
Mailing Address - Zip Code:85607-2407
Mailing Address - Country:US
Mailing Address - Phone:520-364-6463
Mailing Address - Fax:520-364-6503
Practice Address - Street 1:1915 E 10TH ST
Practice Address - Street 2:
Practice Address - City:DOUGLAS
Practice Address - State:AZ
Practice Address - Zip Code:85607-2407
Practice Address - Country:US
Practice Address - Phone:520-364-6463
Practice Address - Fax:520-364-6503
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-12
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7867261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty