Organization
CONNECTICUT GENERAL LIFE INSURANCE COMPANY
Active
Other names
Alegis Care New Jersey PC
Organization subpart
No
Provider details
NPI number
Authorized official
DIRK WALES MD (CEO)
(623) 277-1170
Entity
Organization
Contact information
Practice address
25500 N NORTERRA DR, PHOENIX, AZ 85085-8200
(877) 733-1710
(623) 277-1091
Mailing address
25500 N NORTERRA DR, PHOENIX, AZ 85085-8200
(877) 733-1710
(623) 277-1091
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
10/06/2016
Last updated
12/06/2016
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