| NPI | 1235870205 | 
|---|---|
| Other Name | FUNCTIONAL HEALTHCARE CENTER | 
| Entity Type | Organization | 
| Authorized Contact | ANTHONY TIEDEMANN Owner/Clinical Director 480-747-0499  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 171400000X Health & Wellness Coach | 
| Additional Taxonomies | 261Q00000X Clinic/Center | 
| Enumeration Date | 2022-04-05 | 
| Last Update Date | 2022-04-05 |