Individual
DENNIS GYLLENHAAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
12315 N VISTOSO PARK RD, ORO VALLEY, AZ 85755-5819
(520) 382-8180
(520) 382-8342
Mailing address
PO BOX 31630, TUCSON, AZ 85751-1630
(520) 382-8180
(520) 382-8342
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2967
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2967
PT LICENCE
AZ
05
—
336984
—
AZ
01
—
Z212422
MEDICARE PTAN
AZ
Enumeration date
05/18/2006
Last updated
04/06/2018
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