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Provider Information for 1689822215

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GENESIS HEALTH SYSTEMS

Organization Subpart: NO

Organization NPI: 1689822215

Calendar   Last Updated:  2009-02-20
  Certification Date: 

Details

Name Value
NPI 1689822215
Enumeration Date 2008-09-08
NPI Type 2- Organization
Status Active
Authorized Official Information Name: DR. HENRY LEE EALY NATUROPATHIC DOCTOR
Title: OWNER/EXECUTIVE COMMUNITY DIRECTOR
Phone: 480-284-8155
Mailing Address 209 E BASELINE RD SUITE E102
TEMPE, AZ 85283-1269
United States

Phone: 480-284-8155 | Fax: 866-823-2115
View Map External Link
Primary Practice Address 209 E BASELINE RD SUITE E102
TEMPE, AZ 85283-1269
United States

Phone: 480-284-8155 | Fax: 866-823-2115
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 193200000X MULTI-SPECIALTY GROUP
175F00000X - Naturopath		 AZ 07-1041