Organization
CBD HEALTHCARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CRAIG DEFRIES (OWNER)
(602) 889-5833
Entity
Organization
Contact information
Practice address
4540 E BASELINE RD, #105, MESA, AZ 85206-4613
(602) 889-5833
(602) 889-5834
Mailing address
PO BOX 60264, PHOENIX, AZ 85082-0264
(602) 889-5833
(602) 889-5834
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
—
AZ
171M00000X
Case Manager/Care Coordinator
—
AZ
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
—
AZ
363LF0000X
Family Nurse Practitioner
Primary
—
AZ
Other
Enumeration date
05/20/2014
Last updated
05/22/2014
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