Organization
ARCHER BODYWORKS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WILTON I HALL III MT/BHT (MANAGING MEMBER)
(520) 304-5330
Entity
Organization
Contact information
Practice address
4625 E BROADWAY BLVD STE 114, TUCSON, AZ 85711-3575
(520) 304-5330
Mailing address
933 N MAIN AVE UNIT 131, TUCSON, AZ 85705-7617
(520) 304-5330
Taxonomy
Speciality
Code
Description
License number
State
133NN1002X
Nutrition Education Nutritionist
—
—
174400000X
Specialist
—
—
225700000X
Massage Therapist
Primary
—
—
Other
Enumeration date
05/29/2018
Last updated
05/29/2018
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