| NPI | LastName | FirstName | MidName | Organization | Mailing Address | City | State | Zip |
| 1114230893 | INNOVATIVE HEALTH CARE OF HAVASU LLC | 297 LAKE HAVASU AVE SOUTH | LAKE HAVASU CITY | AZ | 86403 | |||
| 1265862676 | INNOVATIVE HEALTH AND WELLNESS CENTER | 297 LAKE HAVASU AVE S | LAKE HAVASU CITY | AZ | 864036526 | |||
| 1265745277 | TILGNER | SUMMER | YVONNE | 297 S. LAKE HAVASU AVENUE | LAKE HAVASU CITY | AZ | 86403 |