Provider Demographics
NPI:1881447142
Name:ORION WELLNESS CORP
Entity type:Organization
Organization Name:ORION WELLNESS CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:DENTON
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVENPORT
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:602-475-5646
Mailing Address - Street 1:16700 N THOMPSON PEAK PKWY STE 170
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-2386
Mailing Address - Country:US
Mailing Address - Phone:602-475-5646
Mailing Address - Fax:480-750-7119
Practice Address - Street 1:16700 N THOMPSON PEAK PKWY STE 170
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-2386
Practice Address - Country:US
Practice Address - Phone:602-475-5646
Practice Address - Fax:480-750-7119
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-08
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPain