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General NPI Number Information
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NPI Number | 1508442799
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Entity Type | Organization
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Legal Business Name | GALLUS MEDICAL SERVICES ARIZONA
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Dates
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Enumeration Date | 03/19/2021
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Last Update Date | 03/19/2021
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Provider Practice Location Address
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Address Line | 4326 N 75TH ST
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City | SCOTTSDALE
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State | AZ
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Zip | 85251-3505
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Country | US
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Telephone | 480-425-5540
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Fax | 480-361-9023
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Provider Business Mailing Address
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Address Line | 300 S JACKSON ST STE 220
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City | DENVER
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State | CO
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Zip | 80209-3134
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Country | US
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Telephone | 720-501-2227
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Fax | 720-501-2237
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Authorized Official
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Title or Position | MEDICAL REIMBURSEMENT MANAGER
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Name | ANNETTE EDGAR
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Credential |
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Telephone | 720-501-2227
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TP2701X
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Taxonomy Name | Group Psychotherapy Psychologist
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License Number |
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License Number State |
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