Healthcare Provider Details

I. General information

NPI: 1639568470
Provider Name (Legal Business Name): ALPHA MEDICAL GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/16/2015
Last Update Date: 01/16/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3126 S HIGLEY RD STE 102
GILBERT AZ
85295-2030
US

IV. Provider business mailing address

3126 S HIGLEY RD STE 102
GILBERT AZ
85295-2030
US

V. Phone/Fax

Practice location:
  • Phone: 480-988-2974
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number StateNULL

VIII. Authorized Official

Name: DR. BRICE NEFF
Title or Position: SOLE MEMBER
Credential:
Phone: 480-988-2974