Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | 17-1682 | AZ |
NPI | 1023470234 |
---|---|
Provider Name | Andrea Grund |
First Address | Tucson, AZ 85741-2306 |
Second Address | Tucson, AZ 85741-2306 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/03/2016 |
Last Update Date | 25/01/2018 |