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General NPI Number Information
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NPI Number | 1225404965
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Entity Type | Organization
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Legal Business Name | PREFERRED MEDICAL LLC
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Dates
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Enumeration Date | 08/17/2015
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Last Update Date | 08/17/2015
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Provider Practice Location Address
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Address Line | 235 E WARNER RD B 104
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City | GILBERT
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State | AZ
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Zip | 85296-2972
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Country | US
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Telephone | 480-633-3151
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Fax | 480-383-6076
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Provider Business Mailing Address
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Address Line | 235 E WARNER RD B 104
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City | GILBERT
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State | AZ
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Zip | 85296-2972
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Country | US
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Telephone | 480-633-3151
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Fax | 480-383-6076
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Authorized Official
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Title or Position | OWNER
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Name | DR. JEFF ROGERS
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Credential |
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Telephone | 480-633-3151
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP3300X
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Taxonomy Name | Pain Clinic/Center
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License Number |
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License Number State |
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