Provider Demographics
NPI:1598517302
Name:INTEGRATIVE HEALTH ARIZONA LLC
Entity type:Organization
Organization Name:INTEGRATIVE HEALTH ARIZONA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/AO
Authorized Official - Prefix:
Authorized Official - First Name:NESTOR
Authorized Official - Middle Name:
Authorized Official - Last Name:ZENAROSA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:469-420-5544
Mailing Address - Street 1:PO BOX 38571
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-1227
Mailing Address - Country:US
Mailing Address - Phone:469-420-5544
Mailing Address - Fax:
Practice Address - Street 1:5240 E KNIGHT DR STE 100
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-2122
Practice Address - Country:US
Practice Address - Phone:520-329-0354
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-04
Last Update Date:2024-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty