Organization
JUPITER MEDICAL SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL BANGART DPM (MANAGER)
(623) 974-0522
Entity
Organization
Contact information
Practice address
13660 N 94TH DR # D-1, PEORIA, AZ 85381-4836
(623) 974-0522
Mailing address
7558 W. THUNDERBIRD RD., STE. 1, BOX 606, PEORIA, AZ 85381-4836
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
—
—
Other
Enumeration date
07/01/2019
Last updated
12/19/2019
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