| NPI | 1952771024 |
|---|---|
| Doing Business As | DIVINE IV AND WELLNESS |
| Entity Type | Organization |
| Authorized Contact | JOOST BERKHOUT Managing Member 480-718-1444 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AZ AP5244) |
| Enumeration Date | 2015-10-02 |
| Last Update Date | 2024-05-08 |