# RENOVARE CLINIC OF NATURAL MEDICINE PA

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

## Provider details

- **NPI number:** 1902974678
- **Authorized official:** DR. TIMOTHY CHARLES GERHART DC (CEO)
- **Authorized official phone:** (623) 776-0206

## Contact information

- **Practice address:** 18301 NORTH 79TH AVE, SUITE G190, GLENDALE, AZ 85308
- **Practice address phone:** (623) 776-0206
- **Practice address fax:** (623) 776-0282
- **Mailing address:** 18301 NORTH 79TH AVE, SUITE G190, GLENDALE, AZ 85308
- **Mailing address phone:** (623) 776-0206
- **Mailing address fax:** (623) 776-0282

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111N00000X | Chiropractor | 7243 | AZ | — |
| 111NI0900X | Internist Chiropractor | 7243 | AZ | Yes |
| 171100000X | Acupuncturist | 7243 | AZ | — |

## Other

- **Enumeration date:** 12/01/2006
- **Last updated:** 04/08/2008