Provider Demographics
NPI:1720284920
Name:WE CARE OSTEOPATHIC WELLNESS CENTER, P.C.
Entity Type:Organization
Organization Name:WE CARE OSTEOPATHIC WELLNESS CENTER, P.C.
Other - Org Name:WE CARE FAMILY WELLNESS CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:RENDERING PROVIDER
Authorized Official - Prefix:DR
Authorized Official - First Name:JORDAN
Authorized Official - Middle Name:S
Authorized Official - Last Name:ROSS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:480-686-9686
Mailing Address - Street 1:2730 S VAL VISTA DR
Mailing Address - Street 2:SUITE 138 BLDG 7
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85296-6675
Mailing Address - Country:US
Mailing Address - Phone:480-686-9686
Mailing Address - Fax:480-686-9508
Practice Address - Street 1:2730 S VAL VISTA DR
Practice Address - Street 2:SUITE 138 BLDG 7
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85296-6675
Practice Address - Country:US
Practice Address - Phone:480-686-9686
Practice Address - Fax:480-686-9508
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3119204D00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMMGroup - Multi-Specialty
Not Answered207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ3119OtherAZ LICENSE
AZ3119OtherAZ LICENSE
AZZ106071Medicare ID - Type Unspecified