Organization
INNOVATIVE HEALTH AND WELLNESS CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUMMER YVONNE TILGNER FNP (OWNER)
(928) 854-7666
Entity
Organization
Contact information
Practice address
297 LAKE HAVASU AVE S, 200, LAKE HAVASU CITY, AZ 86403-6526
(928) 854-7666
(928) 854-7660
Mailing address
297 LAKE HAVASU AVE S, 200, LAKE HAVASU CITY, AZ 86403-6526
(928) 854-7666
(928) 854-7660
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
13-00030589
AZ
Other
Enumeration date
11/21/2013
Last updated
11/21/2013
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