Organization
1ST ALLEGIANT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CANDICE REED (OWNER)
(480) 332-8436
Entity
Organization
Contact information
Practice address
21798 E CHERRYWOOD DR, QUEEN CREEK, AZ 85142-4886
(480) 332-8436
Mailing address
21798 E CHERRYWOOD DR, QUEEN CREEK, AZ 85142-4886
Taxonomy
Speciality
Code
Description
License number
State
2080P0006X
Developmental - Behavioral Pediatrics Physician
Primary
—
—
Other
Enumeration date
05/11/2018
Last updated
05/11/2018
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