Organization
SEDONA INTEGRATIVE MEDICAL CLINIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICOL MARIE MOODY (OFFICE MANAGER)
(928) 284-0166
Entity
Organization
Contact information
Practice address
450 S WILLARD ST STE 101, COTTONWOOD, AZ 86326-6744
(928) 284-0166
(928) 284-1810
Mailing address
450 S WILLARD ST STE 101, COTTONWOOD, AZ 86326-6744
(928) 284-0166
(928) 284-1810
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
225100000X
Physical Therapist
5669
AZ
Other
Enumeration date
03/05/2009
Last updated
07/18/2022
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