Organization
EDENMD WELLNESS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RUTH FORDE MD (PHYSICIAN, PARTNER, ADMINISTRATOR)
(956) 607-4880
Entity
Organization
Contact information
Practice address
7760 E STATE ROUTE 69 STE C5-342, PRESCOTT VALLEY, AZ 86314-2201
(602) 525-8530
Mailing address
6620 E DESPERADO DR, PRESCOTT VALLEY, AZ 86314-5824
(956) 607-4880
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
10/26/2022
Last updated
11/07/2022
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