Organization
WELLNESS INTEGRATIVE, PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIVYR DERAKHSHAN (OWNER)
(928) 318-6910
Entity
Organization
Contact information
Practice address
1207 W 16TH ST STE B, YUMA, AZ 85364-4597
(928) 318-6310
(928) 328-1056
Mailing address
1207 W 16TH ST STE B, YUMA, AZ 85364-4597
(928) 318-6310
(928) 328-1056
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
03/31/2016
Last updated
04/15/2020
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