OrganizationActive
Integrated Wellness Club
NPI 1811396757 · Health Educator · Lake Havasu City, AZ
Provider details
- NPI number
- 1811396757
- Entity type
- Organization
- Primary specialty
- Health EducatorOther Service Providers
- Organization subpart
- No
- Authorized official
- Rustom Ali, Member, LLC(480) 703-4227
Specialties & taxonomies
Other Service Providers
Practice location
1968 Mesquite Ave
Lake Havasu City, AZ 86403-5729
Phone: (480) 703-4227
Approximate (ZIP-level) locationGet directions
Mailing address
1968 Mesquite Ave
Lake Havasu City, AZ 86403-5729
Registry dates
- Enumerated
- 2014-08-16
- Last updated
- 2014-08-16
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.