Organization
HEARTFIT FOR DUTY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEPRA L JACK (DIRECTOR OF OPERATIONS)
(480) 999-7911
Entity
Organization
Contact information
Practice address
633 E RAY RD, SUITE 101, GILBERT, AZ 85296-4200
(480) 999-7911
(480) 499-5829
Mailing address
633 E RAY RD, SUITE 101, GILBERT, AZ 85296-4200
(480) 999-7911
(480) 499-5829
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
03/28/2013
Last updated
03/29/2013
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