Organization
TERRENCE P GLEASON MD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CARRIE L RIESDORPH (OFFICE MANAGER)
(928) 854-6508
Entity
Organization
Contact information
Practice address
1972 MESQUITE AVE, LAKE HAVASU CITY, AZ 86403-5729
(928) 854-6508
(928) 854-6206
Mailing address
1972 MESQUITE AVE, LAKE HAVASU CITY, AZ 86403-5729
(928) 854-6508
(928) 854-6206
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
24347
AZ
Other
Enumeration date
06/04/2007
Last updated
08/22/2020
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