Organization
PHOENIX WELLNESS AND REJUVENATION LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICOLE NEELY MD (PRACTICE OWNER)
(602) 689-2349
Entity
Organization
Contact information
Practice address
1928 E HIGHLAND AVE STE F104, PHOENIX, AZ 85016-4626
(602) 898-6977
Mailing address
1928 E HIGHLAND AVE STE F104, PHOENIX, AZ 85016-4626
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
05/09/2025
Last updated
05/20/2025
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