Organization
HIGLEY PARK INTEGRATED HEALTH GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANTHONY PIVONKA (MEMBER/MANAGER)
(480) 892-0022
Entity
Organization
Contact information
Practice address
1355 S HIGLEY RD STE 102, GILBERT, AZ 85296-4799
(480) 892-0022
Mailing address
1355 S HIGLEY RD STE 102, GILBERT, AZ 85296-4799
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
05/14/2019
Last updated
05/14/2019
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