| Achieve More Sports And Wellness, Pllc | |
|
6139 S Rural Rd Ste 102 Tempe AZ 85283-2929 | |
| (480) 846-0688 | |
| (480) 741-8650 |
| Full Name | Achieve More Sports And Wellness, Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 6139 S Rural Rd Ste 102, Tempe, Arizona |
| Authorized Official Name and Position | Stacey Louise Dault (OWNER) |
| Authorized Official Contact | 6024138710 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Achieve More Sports And Wellness, Pllc Po Box 6085 Chandler AZ 85246-6085 Ph: (602) 413-8710 | Achieve More Sports And Wellness, Pllc 6139 S Rural Rd Ste 102 Tempe AZ 85283-2929 Ph: (480) 846-0688 |
| NPI Number | 1558012021 |
|---|---|
| Provider Enumeration Date | 01/15/2022 |
| Last Update Date | 04/09/2024 |
| Medicare PECOS PAC ID | 5294128120 |
|---|---|
| Medicare Enrollment ID | O20220216002642 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558012021 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Stacey Louise Dault |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1760775357 PECOS PAC ID: 1759503980 Enrollment ID: I20160115000512 |
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