# PRISM WELLNESS CENTER PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1407607336
- **Authorized official:** CAROLYN COLLIER NP (NP)
- **Authorized official phone:** (610) 772-3325

## Contact information

- **Practice address:** 9299 W OLIVE AVE STE 604, PEORIA, AZ 85345-8386
- **Practice address phone:** (610) 772-3325
- **Practice address fax:** (866) 398-8310
- **Mailing address:** 14175 W INDIAN SCHOOL RD \# SETB4195, GOODYEAR, AZ 85395-8407
- **Mailing address phone:** (610) 772-3325
- **Mailing address fax:** (866) 398-8310

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 03/28/2024
- **Last updated:** 09/05/2024