Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | 97-505 | AZ |
NPI | 1144369448 |
---|---|
Provider Name | Dr. Adam P Kerievsky |
First Address | Goodyear, AZ 85338-3007 |
Second Address | Goodyear, AZ 85338-3007 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/02/2007 |
Last Update Date | 31/03/2016 |