Organization
M.G.T RN LLC
Active
Other names
MGT MD at Home
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JAMEELAH WILSON FNP (OWNER)
(480) 430-0721
Entity
Organization
Contact information
Practice address
7117 E PERALTA CIR, MESA, AZ 85212-9825
(480) 430-0721
Mailing address
7316 E SOUTHERN AVE UNIT 6091, MESA, AZ 85216-5005
(480) 430-0721
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
02/09/2020
Last updated
02/09/2020
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