Provider Demographics
NPI:1871288878
Name:NOURISH NATURAL MEDICAL CENTER
Entity type:Organization
Organization Name:NOURISH NATURAL MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NATALIE
Authorized Official - Middle Name:
Authorized Official - Last Name:HAM
Authorized Official - Suffix:
Authorized Official - Credentials:ND
Authorized Official - Phone:480-361-3844
Mailing Address - Street 1:4450 S. RURAL RD
Mailing Address - Street 2:BLDG A, STE 210
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85282
Mailing Address - Country:US
Mailing Address - Phone:480-361-3844
Mailing Address - Fax:480-771-3669
Practice Address - Street 1:4450 S. RURAL RD
Practice Address - Street 2:BLDG A, STE 210
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85282
Practice Address - Country:US
Practice Address - Phone:480-361-3844
Practice Address - Fax:480-771-3669
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-06
Last Update Date:2023-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175F00000XOther Service ProvidersNaturopathGroup - Single Specialty