Healthcare Provider Details
I. General information
NPI: 1114163599
Provider Name (Legal Business Name): GTL PROPERTIES LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/06/2009
Last Update Date: 02/02/2009
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3605 W CORTARO FARMS RD STE 145
TUCSON AZ
85742-8683
US
IV. Provider business mailing address
3605 W CORTARO FARMS RD STE 145
TUCSON AZ
85742-8683
US
V. Phone/Fax
- Phone: 520-579-2424
- Fax: 520-579-2426
- Phone: 520-579-2424
- Fax: 520-579-2426
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261Q00000X |
| Taxonomy | Clinic/Center |
| License Number | 7387 |
| License Number State | AZ |
VIII. Authorized Official
Name: DR.
CHRISTINA
MAE
KESZLER
Title or Position: DR. OF CHIROPRACTIC
Credential: BSC. DC
Phone: 520-579-2424