1st Allegiant LLC
Pediatrics, Developmental - Behavioral Pediatrics in Queen Creek, AZ. Organization (NPI-2).
NPI number1982194387
StatusActive
Last updated in NPPESMay 11, 2018
Details
- NPI
- 1982194387
- Entity type
- Organization (NPI-2)
- Legal business name
- 1st Allegiant LLC
- Organization subpart
- No
- Enumeration date
- May 11, 2018
- Last updated
- May 11, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2080P0006X | Pediatrics, Developmental - Behavioral Pediatrics | – | – | Yes |
Practice location
21798 E Cherrywood DrQueen Creek, AZ 85142-4886
Phone 480-332-8436
Mailing address
21798 E Cherrywood DrQueen Creek, AZ 85142-4886
Authorized official
Candice Reed
Owner
4803328436
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