Healthcare Provider Details

I. General information

NPI: 1760545438
Provider Name (Legal Business Name): SYNERGY PEDIATRIC THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/17/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

835 W WARNER RD SUITE 101-473
GILBERT AZ
85233-7269
US

IV. Provider business mailing address

835 W WARNER RD SUITE 101-473
GILBERT AZ
85233-7269
US

V. Phone/Fax

Practice location:
  • Phone: 480-247-2833
  • Fax: 480-247-2833
Mailing address:
  • Phone: 480-247-2833
  • Fax: 480-247-2833

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MELANIE IRENE CONATSER
Title or Position: CO-DIRECTOR
Credential: OTRL
Phone: 480-247-2833