Individual
DENISE L. KELLEY GANTT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.C.
Contact information
Practice address
3510 N 24TH ST, SUITE B, PHOENIX, AZ 85016-6608
(602) 402-1904
Mailing address
416 W 11TH ST, TEMPE, AZ 85281-5516
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
8093
AZ
Other
Enumeration date
01/09/2010
Last updated
02/19/2010
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