Provider Demographics
NPI:1962677815
Name:CHAMPION NATUROPATHIC HEALTH, LLC
Entity Type:Organization
Organization Name:CHAMPION NATUROPATHIC HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NATUROPATHIC PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:NATHAN
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:CHAMPION
Authorized Official - Suffix:
Authorized Official - Credentials:ND
Authorized Official - Phone:480-705-9611
Mailing Address - Street 1:4035 W CHANDLER BLVD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85226-3772
Mailing Address - Country:US
Mailing Address - Phone:480-705-9611
Mailing Address - Fax:
Practice Address - Street 1:4035 W CHANDLER BLVD
Practice Address - Street 2:SUITE 1
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85226-3772
Practice Address - Country:US
Practice Address - Phone:480-705-9611
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-22
Last Update Date:2008-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ07-1009175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175F00000XOther Service ProvidersNaturopathGroup - Single Specialty