| Jtch LLC | |
|
2730 S Val Vista Dr Ste 152 Gilbert AZ 85295-1682 | |
| (480) 466-6156 | |
| Not Available |
| Full Name | Jtch LLC |
|---|---|
| Speciality | General Practice |
| Location | 2730 S Val Vista Dr Ste 152, Gilbert, Arizona |
| Authorized Official Name and Position | Trevor T Ferguson (OWNER) |
| Authorized Official Contact | 4803311745 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jtch LLC 2730 S Val Vista Dr Ste 152 Gilbert AZ 85295-1682 Ph: (480) 466-6156 | Jtch LLC 2730 S Val Vista Dr Ste 152 Gilbert AZ 85295-1682 Ph: (480) 466-6156 |
| NPI Number | 1457915381 |
|---|---|
| Provider Enumeration Date | 04/25/2019 |
| Last Update Date | 02/15/2023 |
| Certification Date | 02/15/2023 |
| Medicare PECOS PAC ID | 7416320569 |
|---|---|
| Medicare Enrollment ID | O20230310001310 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457915381 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | () | Primary |
| Provider Name | Trevor T Ferguson |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1285827030 PECOS PAC ID: 2961591276 Enrollment ID: I20071208000184 |
| Provider Name | Cherie Mcintyre |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245861525 PECOS PAC ID: 8022448463 Enrollment ID: I20200425000202 |
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