Organization
PHOENIX HOLISTIC & NUTRITIONAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TONYA L DAVIS ND (OWNER)
(331) 264-0736
Entity
Organization
Contact information
Practice address
10 N ORCHARD ST, IPAVA, IL 61441-5289
(309) 204-5133
Mailing address
10 N ORCHARD ST, IPAVA, IL 61441-5289
(309) 204-5133
Taxonomy
Speciality
Code
Description
License number
State
133NN1002X
Nutrition Education Nutritionist
—
—
171400000X
Health & Wellness Coach
Primary
—
—
173C00000X
Reflexologist
—
—
175T00000X
Peer Specialist
—
—
225600000X
Dance Therapist
—
—
332U00000X
Home Delivered Meals
—
—
374J00000X
Doula
—
—
Other
Enumeration date
12/29/2025
Last updated
12/29/2025
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