Full Spectrum Wellness Inc | |
7660 E Broadway Blvd Ste 210 Tucson AZ 85710-3775 | |
(626) 215-5900 | |
Not Available |
Full Name | Full Spectrum Wellness Inc |
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Speciality | General Practice |
Location | 7660 E Broadway Blvd Ste 210, Tucson, Arizona |
Authorized Official Name and Position | Kristin Makinajyan (DIRECTOR) |
Authorized Official Contact | 6262155900 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Full Spectrum Wellness Inc 7660 E Broadway Blvd Ste 210 Tucson AZ 85710-3775 Ph: () - | Full Spectrum Wellness Inc 7660 E Broadway Blvd Ste 210 Tucson AZ 85710-3775 Ph: (626) 215-5900 |
NPI Number | 1447094230 |
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Provider Enumeration Date | 06/25/2024 |
Last Update Date | 06/25/2024 |
Medicare PECOS PAC ID | 6103359666 |
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Medicare Enrollment ID | O20241023001699 |
Identifier | Type | State | Issuer |
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1447094230 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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208D00000X | General Practice | (* (Not Available)) | Primary |
Provider Name | Alessandra L Clark |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1942681143 PECOS PAC ID: 1850648775 Enrollment ID: I20190319000431 |
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