Provider Demographics
NPI:1699353870
Name:BIBLICAL BOTANICALS LLC.
Entity Type:Organization
Organization Name:BIBLICAL BOTANICALS LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REVEREND /OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:HERTZBERG
Authorized Official - Suffix:
Authorized Official - Credentials:REIKI MASTER TCM
Authorized Official - Phone:480-290-6071
Mailing Address - Street 1:3617 W EL CAMINO DR
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85051-9119
Mailing Address - Country:US
Mailing Address - Phone:480-290-6071
Mailing Address - Fax:480-290-6071
Practice Address - Street 1:3617 W EL CAMINO DR
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85051-9119
Practice Address - Country:US
Practice Address - Phone:480-290-6071
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-30
Last Update Date:2021-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1710I1003XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Medical TechniciansGroup - Multi-Specialty