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General NPI Number Information
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NPI Number | 1811441124
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Entity Type | Organization
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Legal Business Name | STONEGATE DEVELOPMENT, LLC
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Dates
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Enumeration Date | 08/04/2016
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Last Update Date | 08/04/2016
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Provider Practice Location Address
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Address Line | 2451 E BASELINE RD SUITE 240
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City | GILBERT
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State | AZ
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Zip | 85234-2471
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Country | US
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Telephone | 480-999-7200
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Fax |
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Provider Business Mailing Address
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Address Line | 2451 E BASELINE RD SUITE 240
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City | GILBERT
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State | AZ
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Zip | 85234-2471
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | MONICA ROGERS
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Credential | O.T.
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Telephone | 480-304-1245
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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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