| Kai Health & Wellness, LLC | |
|
16620 N 40th St Building I, Suite 2 Phoenix AZ 85032-3348 | |
| (480) 315-8322 | |
| Not Available |
| Full Name | Kai Health & Wellness, LLC |
|---|---|
| Speciality | Family Medicine |
| Location | 16620 N 40th St, Phoenix, Arizona |
| Authorized Official Name and Position | Eric Poole (MEMBER/MANAGER) |
| Authorized Official Contact | 6024930004 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kai Health & Wellness, LLC 36010 N 33rd Ln Phoenix AZ 85086-2298 | Kai Health & Wellness, LLC 16620 N 40th St Building I, Suite 2 Phoenix AZ 85032-3348 Ph: (480) 315-8322 |
| NPI Number | 1881117273 |
|---|---|
| Provider Enumeration Date | 07/18/2017 |
| Last Update Date | 07/24/2017 |
| Medicare PECOS PAC ID | 1658643655 |
|---|---|
| Medicare Enrollment ID | O20170825003006 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881117273 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QS0010X | Family Medicine - Sports Medicine | () | Primary |
| Provider Name | Eric L Poole |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1871628768 PECOS PAC ID: 6507892262 Enrollment ID: I20050713001015 |
| Provider Name | William B Risley |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1871549659 PECOS PAC ID: 6305946450 Enrollment ID: I20070703000239 |
| Provider Name | Andre N Khoury |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1972803336 PECOS PAC ID: 7719160373 Enrollment ID: I20130419000387 |
| Provider Name | Patricia L Henthorn |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1184758195 PECOS PAC ID: 2961452529 Enrollment ID: I20150817002084 |
| Provider Name | Yan Y Suleymanov |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1992282651 PECOS PAC ID: 5991055345 Enrollment ID: I20180905001376 |
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