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Individual

DR. GREGORY HELLER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
19389 N 59TH AVE, GLENDALE, AZ 85308-6500
(623) 537-6000
Mailing address
19389 N 59TH AVE, GLENDALE, AZ 85308-6500
(623) 537-6000

Taxonomy

Speciality
Code
Description
License number
State
204D00000X
Neuromusculoskeletal Medicine & OMM Physician
0102206528
VA
207Q00000X
Family Medicine Physician
Primary
006017
AZ
207Q00000X
Family Medicine Physician
R1704
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
R1704
TRAINING PERMIT
AZ
Enumeration date
07/01/2009
Last updated
04/30/2021
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