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Functional Medicine Center of Arizona — NPI 1235870205, Phoenix, AZ | NPI Central

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NPI 1235870205

OrganizationActive

Functional Medicine Center of Arizona

NPI 1235870205 · Health & Wellness Coach · Phoenix, AZ

Provider details

NPI number: 1235870205
Entity type: Organization
Primary specialty: Health & Wellness CoachOther Service Providers
Organization subpart: No
Authorized official: Anthony Tiedemann, Owner/Clinical Director(480) 747-0499

Specialties & taxonomies

Health & Wellness CoachPrimary171400000X
Other Service Providers
Clinic/Center261Q00000X
Ambulatory Health Care Facilities

Practice location

806 S 56th Ave Ste 1b

Phoenix, AZ 85043-4630

Phone: (602) 429-0447

Approximate (ZIP-level) locationGet directions

More AZ providers

Mailing address

806 S 56th Ave Ste 1b

Phoenix, AZ 85043-4630

Other names (DBA / former)

Other name: Functional Healthcare Center

Registry dates

Enumerated: 2022-04-05
Last updated: 2022-04-05
Certified: 2022-04-04

Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.