Organization
MAA WELLNESS CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ANGELA GRAGG R.N. (PRESIDENT)
(602) 305-4719
Entity
Organization
Contact information
Practice address
3146 E WIER AVE RM 19, PHOENIX, AZ 85040-2754
(602) 305-4719
Mailing address
3146 E WIER AVE, RM 19, PHOENIX, AZ 85040-2754
(602) 305-4719
Taxonomy
Speciality
Code
Description
License number
State
133NN1002X
Nutrition Education Nutritionist
Primary
—
—
171100000X
Acupuncturist
—
—
175F00000X
Naturopath
—
—
225700000X
Massage Therapist
—
—
2278G1100X
General Care Certified Respiratory Therapist
—
—
Other
Enumeration date
07/10/2019
Last updated
09/27/2019
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