Provider Demographics
NPI:1922426956
Name:HOLISTIC MEDICAL GROUP
Entity Type:Organization
Organization Name:HOLISTIC MEDICAL GROUP
Other - Org Name:HMG
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHWARY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-969-1471
Mailing Address - Street 1:445 E HUBER ST
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85203-3645
Mailing Address - Country:US
Mailing Address - Phone:480-969-1471
Mailing Address - Fax:480-269-9426
Practice Address - Street 1:32 S MACDONALD
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85210-1310
Practice Address - Country:US
Practice Address - Phone:480-969-1472
Practice Address - Fax:480-269-9426
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-07
Last Update Date:2014-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup PsychotherapyGroup - Multi-Specialty