Provider Demographics
NPI:1043789712
Name:RICH, GREGORY
Entity type:Individual
Prefix:
First Name:GREGORY
Middle Name:
Last Name:RICH
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16421 N TATUM BLVD STE 129
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85032-3456
Mailing Address - Country:US
Mailing Address - Phone:480-380-0030
Mailing Address - Fax:
Practice Address - Street 1:16421 N TATUM BLVD STE 129
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85032-3456
Practice Address - Country:US
Practice Address - Phone:801-664-3575
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-24
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath