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General NPI Number Information
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NPI Number | 1538540414
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Entity Type | Individual
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Provider Name | MARSHA GILL OMT COM
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Gender | Female
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Dates
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Enumeration Date | 06/16/2015
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 14050 N 83RD AVE SUITE 290
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City | PEORIA
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State | AZ
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Zip | 85381-5638
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Country | US
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Telephone | 602-796-6070
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Fax | 888-796-9570
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Provider Business Mailing Address
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Address Line | 8447 W DESERT ELM LN
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City | PEORIA
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State | AZ
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Zip | 85383-3645
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Country | US
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Telephone | 602-796-6070
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Fax | 888-796-9570
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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 | 125J00000X
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Taxonomy Name | Dental Therapist
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License Number | 554
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 125Q00000X
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Taxonomy Name | Oral Medicine Dentistry
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License Number | 554
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License Number State | AZ
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Taxonomy #3
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 554
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License Number State | AZ
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