Provider Demographics
NPI:1891049912
Name:SUMMERS, ALISA JOY (ND)
Entity type:Individual
Prefix:
First Name:ALISA
Middle Name:JOY
Last Name:SUMMERS
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:821 W WARNER RD
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85225-2926
Mailing Address - Country:US
Mailing Address - Phone:480-999-4230
Mailing Address - Fax:480-999-4231
Practice Address - Street 1:821 W WARNER RD
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85225-2926
Practice Address - Country:US
Practice Address - Phone:480-999-4230
Practice Address - Fax:480-999-4231
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-29
Last Update Date:2012-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ12-1332175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath