Mountainside Wellness Center Inc | |
16515 S 40th St Ste 129, Phoenix, AZ 85048-0560 | |
(480) 940-7444 | |
Not Available |
Full Name | Mountainside Wellness Center Inc |
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Type | Facility |
Speciality | Chiropractor |
Location | 16515 S 40th St Ste 129, Phoenix, Arizona |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
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1053583450 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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111N00000X | Chiropractor | 7077 (Arizona) | Primary |
208100000X | Physical Medicine & Rehabilitation | 3751 (Arizona) | Secondary |
Provider Name | John S Mettham |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1235227364 PECOS PAC ID: 7416942024 Enrollment ID: I20120813000587 |
Mailing Address | Practice Location Address |
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Mountainside Wellness Center Inc 4909 E Chandler Blvd Ste 502, Phoenix, AZ 85048-0863 Ph: () - | Mountainside Wellness Center Inc 16515 S 40th St Ste 129, Phoenix, AZ 85048-0560 Ph: (480) 940-7444 |
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