Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Ageless Nutrition Bar Holdings, Inc

Organization Adult Medicine Physician · NPI 1932704830

Ageless Nutrition Bar Holdings, Inc is an Adult Medicine Physician in Phoenix, Arizona. Registered with an NPI since 2020.

In the registry since
2020
Specialties on file
2
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

4802 E Ray Rd # 9
Phoenix, AZ 85044-6405
Phone: (901) 757-3643
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Adult Medicine Physician (primary) Taxonomy 207QA0505X
Primary Care Clinic/Center Taxonomy 261QP2300X

Record details

NPI number1932704830
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Teah Smith — Credentialing Manager · (901) 205-3999
Other names Ageless Men'S Health; Ageless Men'S Health
NPI enumeratedDecember 1, 2020
Last updated in NPPESNovember 13, 2023
Certification dateNovember 13, 2023
Mailing address4802 E Ray Rd # 9, Phoenix, AZ 85044-6405

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