Organization
ICONIC HUMAN DESIGN, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAVEENA BRIANNE ARCHERS PHD (MEMBER MANAGER)
(928) 948-7388
Entity
Organization
Contact information
Practice address
180 S MERRITT RANCH RD, CORNVILLE, AZ 86325-5733
(928) 848-7388
Mailing address
1771 W ST RTE 89A STE 2516, SEDONA, AZ 86336-5594
(928) 948-7388
Taxonomy
Speciality
Code
Description
License number
State
174200000X
Meals Provider
Primary
—
—
Other
Enumeration date
06/30/2025
Last updated
06/30/2025
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