Provider Demographics
NPI:1851046940
Name:MAXWELL, ALLEN (ND)
Entity Type:Individual
Prefix:DR
First Name:ALLEN
Middle Name:
Last Name:MAXWELL
Suffix:
Gender:M
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1904 E MANHATTON DR
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85282-5816
Mailing Address - Country:US
Mailing Address - Phone:928-257-4873
Mailing Address - Fax:602-666-3979
Practice Address - Street 1:1904 E MANHATTON DR
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85282-5816
Practice Address - Country:US
Practice Address - Phone:928-257-4873
Practice Address - Fax:602-666-3979
Is Sole Proprietor?:No
Enumeration Date:2022-02-16
Last Update Date:2022-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ22-1704175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath