Provider Demographics
NPI:1538985460
Name:SUN VALLEY HEALTH & WELLNESS LLC
Entity type:Organization
Organization Name:SUN VALLEY HEALTH & WELLNESS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:POLSON
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:602-721-9787
Mailing Address - Street 1:12361 W BOLA DR STE 107
Mailing Address - Street 2:
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85378-9021
Mailing Address - Country:US
Mailing Address - Phone:623-266-1333
Mailing Address - Fax:602-773-5674
Practice Address - Street 1:12361 W BOLA DR STE 107
Practice Address - Street 2:
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85378-9021
Practice Address - Country:US
Practice Address - Phone:623-266-1333
Practice Address - Fax:602-773-5674
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-25
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty