Most Relevant Information
Provider Data
| NPI Number: | 1003444894 |
| Provider Name: | SHEA NICOLE GALLUS |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 03/29/2020 |
| Last Updated: | 06/04/2023 |
Provider Practice Location
1919 E THOMAS RD
PHOENIX
AZ
850167710
Practice Location Phone/Fax
| Phone: | 6029331000 |
| Fax: |
Provider Mailing Location
1919 E THOMAS RD
PHOENIX
AZ
850167710
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |