| Gilbert Physical Medicine Llc | |
|
725 W Elliot Rd Suite 115 Gilbert AZ 85233-5301 | |
| (480) 545-0000 | |
| (480) 545-7615 |
| Full Name | Gilbert Physical Medicine Llc |
|---|---|
| Speciality | General Practice |
| Location | 725 W Elliot Rd, Gilbert, Arizona |
| Authorized Official Name and Position | Alisa Wasserman (OWNER/OPERATOR) |
| Authorized Official Contact | 4805450000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gilbert Physical Medicine Llc 725 W Elliot Rd Suite 115 Gilbert AZ 85233-5301 Ph: (480) 545-0000 | Gilbert Physical Medicine Llc 725 W Elliot Rd Suite 115 Gilbert AZ 85233-5301 Ph: (480) 545-0000 |
| NPI Number | 1265708317 |
|---|---|
| Provider Enumeration Date | 03/22/2012 |
| Last Update Date | 03/22/2012 |
| Medicare PECOS PAC ID | 2466697982 |
|---|---|
| Medicare Enrollment ID | O20130403000425 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265708317 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | David C Johnson |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1023088531 PECOS PAC ID: 7012991011 Enrollment ID: I20040616001348 |
| Provider Name | Alisa M Wasserman |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1124061916 PECOS PAC ID: 4284669292 Enrollment ID: I20050928001052 |
| Provider Name | Bradley Christopher Doan |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1598904096 PECOS PAC ID: 7012056013 Enrollment ID: I20091204000279 |
| Provider Name | Ann Cheri Foxx Leach |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1639110455 PECOS PAC ID: 5395716435 Enrollment ID: I20110922000691 |
| Provider Name | Thomas A Morgan |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1578538898 PECOS PAC ID: 6901866763 Enrollment ID: I20120703000475 |
| Provider Name | Ambrosia M Boyd |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336647692 PECOS PAC ID: 8426312158 Enrollment ID: I20180504002192 |
| Provider Name | Shannon Grace Chittenden |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356947550 PECOS PAC ID: 5890184790 Enrollment ID: I20211116000011 |
| Provider Name | Bryce Bisching |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1548658974 PECOS PAC ID: 6608190251 Enrollment ID: I20221004000920 |
| Provider Name | Curtis Casady |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1972588218 PECOS PAC ID: 2264597244 Enrollment ID: I20230227002640 |
| Provider Name | Lauren Ragazzo |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1205245859 PECOS PAC ID: 3274845110 Enrollment ID: I20230414000969 |
| Provider Name | Robert William Wolff |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1639951130 PECOS PAC ID: 6800230145 Enrollment ID: I20240214004477 |
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