Divine Iv And Wellness

LBN: East Valley Joint Clinic Llc
Divine Iv And Wellness is an health care organization with primary practice located at 3930 S Alma School Rd Ste 10 , Chandler AZ 85248-4510. The organization recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as the primary health care specialty. East Valley Joint Clinic Llc can be contacted via phone (480) 718-1444, or through Berkhout, Joost via phone (480) 718-1444.

Contact Information

Primary practice address
3930 S Alma School Rd Ste 10 Chandler AZ 85248-4510
Phone: (480) 718-1444
Fax: (480) 718-7729
Website:
Map and Directions
Authorized official contact:
Name: Berkhout, Joost
Phone: (480) 718-1444

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X AP5244 Arizona

Profile Details

NPI number 1952771024
LBN Legal business name East Valley Joint Clinic Llc
DBA Doing business as Divine Iv And Wellness
Authorized official Berkhout, Joost
Entity Organization
Organization subpart 1 No
Enumeration date Oct 2nd, 2015
Last updated May 8th, 2024 - about 2 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1952771024 NPPES
Arizona MEDICAID 100091

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