Provider Demographics
NPI:1831919083
Name:KALAVESIS, ZANE ALEXANDER (NMD)
Entity type:Individual
Prefix:
First Name:ZANE
Middle Name:ALEXANDER
Last Name:KALAVESIS
Suffix:
Gender:M
Credentials:NMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7501 E MCDOWELL RD APT 2219
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85257-3569
Mailing Address - Country:US
Mailing Address - Phone:805-279-1121
Mailing Address - Fax:
Practice Address - Street 1:4540 E BASELINE RD STE 113
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85206-4617
Practice Address - Country:US
Practice Address - Phone:855-347-3543
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-14
Last Update Date:2024-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ24-1882175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath