Healthcare Provider Details

I. General information

NPI: 1801592480
Provider Name (Legal Business Name): HEALTHYU GILBERT VAL VISTA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/06/2023
Last Update Date: 02/06/2023
Certification Date: 02/04/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3530 S VAL VISTA DR # C101
GILBERT AZ
85297-7318
US

IV. Provider business mailing address

840 E MCKELLIPS RD STE 105
MESA AZ
85203-9654
US

V. Phone/Fax

Practice location:
  • Phone: 602-491-0703
  • Fax:
Mailing address:
  • Phone: 602-491-0701
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332900000X
TaxonomyNon-Pharmacy Dispensing Site
License Number
License Number State

VIII. Authorized Official

Name: SHANE SPEIRS
Title or Position: PRESIDENT
Credential: MD
Phone: 480-495-5485