OrganizationActive
Nova Via Glendale LLC
NPI 1801764212 · Integrative Medicine Physician · Glendale, AZ
Provider details
- NPI number
- 1801764212
- Entity type
- Organization
- Primary specialty
- Integrative Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Stephanie Jolly, Chief Compliance Officer(480) 543-7432
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Behavioral Health & Social Service Providers
- Mental Health Counselor101YM0800X
Behavioral Health & Social Service Providers
- Social Worker104100000X
Behavioral Health & Social Service Providers
- Behavior Technician106S00000X
Behavioral Health & Social Service Providers
- Chiropractor111N00000X
Chiropractic Providers
- Nutritionist133N00000X
Dietary & Nutritional Service Providers
Practice location
6830 N 55th Ave
Suite 100
Glendale, AZ 85301
Phone: (480) 543-7432
Approximate (ZIP-level) locationGet directions
Mailing address
6830 N 55th Ave
Glendale, AZ 85301
Registry dates
- Enumerated
- 2025-10-27
- Last updated
- 2025-10-27
- Certified
- 2025-10-27
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.