Provider Demographics
NPI:1306619044
Name:PAZ WELLNESS
Entity type:Organization
Organization Name:PAZ WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:STOLWORTHY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:435-757-7534
Mailing Address - Street 1:PO BOX 369
Mailing Address - Street 2:
Mailing Address - City:HYDE PARK
Mailing Address - State:UT
Mailing Address - Zip Code:84318-0369
Mailing Address - Country:US
Mailing Address - Phone:435-994-7500
Mailing Address - Fax:
Practice Address - Street 1:169 N GATEWAY DR # 110
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:UT
Practice Address - Zip Code:84332-9707
Practice Address - Country:US
Practice Address - Phone:435-994-7500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-03
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty