Individual
LEISA MARIE MELODY GRGULA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DC
Contact information
Practice address
18261 N PIMA RD STE 115, SCOTTSDALE, AZ 85255-6232
(602) 493-2228
(602) 493-2262
Mailing address
18261 N PIMA RD STE 115, SCOTTSDALE, AZ 85255-6232
(602) 493-2228
(602) 493-2262
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
DC5614
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AZ0243640
BXBS
AZ
Enumeration date
07/15/2005
Last updated
04/03/2020
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