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General NPI Number Information
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NPI Number | 1033659685
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Entity Type | Individual
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Provider Name | PAMELA GANGLER
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Gender | Female
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Dates
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Enumeration Date | 03/01/2017
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Last Update Date | 03/01/2017
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Provider Practice Location Address
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Address Line | 1801 S JENTILLY LN SUITE A-14
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City | TEMPE
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State | AZ
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Zip | 85281-5758
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Country | US
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Telephone | 480-744-5227
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Fax |
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Provider Business Mailing Address
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Address Line | 2251 W MONTEREY AVE
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City | MESA
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State | AZ
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Zip | 85202-7329
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Country | US
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Telephone | 480-250-0733
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 1072
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License Number State | AZ
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