Organization
RENOVARE CLINIC OF NATURAL MEDICINE PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TIMOTHY CHARLES GERHART DC (CEO)
(623) 776-0206
Entity
Organization
Contact information
Practice address
18301 NORTH 79TH AVE, SUITE G190, GLENDALE, AZ 85308
(623) 776-0206
(623) 776-0282
Mailing address
18301 NORTH 79TH AVE, SUITE G190, GLENDALE, AZ 85308
(623) 776-0206
(623) 776-0282
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
7243
AZ
111NI0900X
Internist Chiropractor
Primary
7243
AZ
171100000X
Acupuncturist
7243
AZ
Other
Enumeration date
12/01/2006
Last updated
04/08/2008
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