NPI 1518779461
NPI 1518779461 is a General Practice Physician in Gilbert, Arizona. Registered with an NPI since 2025.
- In the registry since
- 2025
Practice location Address checks out
920 W Breckenridge AveGilbert, AZ 85233-3762
Phone: (520) 399-5671
Fax: (480) 900-8472
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Specialties & licences
| General Practice Physician (primary) | Taxonomy 208D00000X |
|---|
Record details
| NPI number | 1518779461 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Carlos Herrera — Manager · (520) 399-5671 |
| Other names | Premierwound.Care |
| NPI enumerated | January 27, 2025 |
| Last updated in NPPES | January 27, 2025 |
| Certification date | January 26, 2025 |
| Mailing address | 920 W Breckenridge Ave, Gilbert, AZ 85233-3762 |
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