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Specialty details in registry · Casa Grande, AZ

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At a glance

351 N Peart Rd Apt 713, Casa Grande, AZ 85122-4290

NPPES record updated Jul 11, 2025. Public records can lag behind changes at a practice.

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Insurance participation and appointment availability are not established by these public records.

Practice location

351 N Peart Rd Apt 713
Casa Grande, AZ 85122-4290
Professional details: NPI, taxonomy & registry record
NPI1588555254
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Registry details

Primary taxonomy
Specialty details in registry
Taxonomy code
103K00000X
Enumeration date
Jul 11, 2025
Record updated
Jul 11, 2025
More registry details
Provider type
Organization · Type 2

Reported taxonomies and licenses

Specialty details in registry

103K00000X · Primary

License numbers and credentials are reported to NPPES; HCPList does not independently verify them.

Practice location

351 N Peart Rd Apt 713
Casa Grande, AZ 85122-4290
Phone
(520) 424-8089
Mailing address
351 N PEART RD APT 713

CASA GRANDE, AZ 851224290
Source: NPPES Source through Oct 18, 2026An NPI does not verify licensure or credentials.

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