Organization
EMBRY RIDDLE WELLNESS CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SANDRA PALMER RN (DIRECTOR)
(928) 777-6653
Entity
Organization
Contact information
Practice address
3700 WILLOW CREEK RD, PRESCOTT, AZ 86301-3721
(928) 777-6653
Mailing address
3700 WILLOW CREEK RD, PRESCOTT, AZ 86301-3721
(928) 777-6653
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1649376831
PETER POWERS MD TYPE I NPI
AZ
01
—
1730289380
ELLEN BUNCH MD TYPE I NPI
AZ
Enumeration date
02/19/2013
Last updated
02/19/2013
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