Gilbert Physical Medicine LLC
General Practice in Gilbert, AZ. Organization (NPI-2).
NPI number1265708317
StatusActive
Last updated in NPPESMar 22, 2012
Details
- NPI
- 1265708317
- Entity type
- Organization (NPI-2)
- Legal business name
- Gilbert Physical Medicine LLC
- Organization subpart
- No
- Enumeration date
- Mar 22, 2012
- Last updated
- Mar 22, 2012
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 208D00000X | General Practice | – | – | Yes |
Practice location
725 W Elliot RdSuite 115
Gilbert, AZ 85233-5301
Phone 480-545-0000 · Fax 480-545-7615
Mailing address
725 W Elliot RdSuite 115
Gilbert, AZ 85233-5301
Phone 480-545-0000 · Fax 480-545-7615
Authorized official
Alisa Wasserman
Owner/Operator
4805450000
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