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Organization
HEARTFIT FOR DUTY LLC
Active
Organization
HEARTFIT FOR DUTY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KEPRA L JACK RN (DIRECTOR OF OPERATIONS)
(602) 402-5090
Entity
Organization
Contact information
Practice address
633 E RAY RD, SUITE 101, GILBERT, AZ 85296-4200
(480) 999-7911
(480) 499-5829
Mailing address
4192 E PALM BEACH DR, CHANDLER, AZ 85249-7398
(602) 402-5090
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
363LA2200X
Adult Health Nurse Practitioner
AP3059
AZ
Other
Enumeration date
03/02/2012
Last updated
04/02/2013
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