Provider Demographics
NPI:1528051059
Name:SALLIGATORS INC.
Entity type:Organization
Organization Name:SALLIGATORS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:SALLY
Authorized Official - Middle Name:H
Authorized Official - Last Name:DENNY
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:480-272-5505
Mailing Address - Street 1:41149 N COYOTE RD
Mailing Address - Street 2:
Mailing Address - City:QUEEN CREEK
Mailing Address - State:AZ
Mailing Address - Zip Code:85242-9680
Mailing Address - Country:US
Mailing Address - Phone:480-272-5505
Mailing Address - Fax:480-987-6573
Practice Address - Street 1:100 TILBURY RD.
Practice Address - Street 2:
Practice Address - City:KEARNY
Practice Address - State:AZ
Practice Address - Zip Code:85237
Practice Address - Country:US
Practice Address - Phone:480-272-5505
Practice Address - Fax:480-987-6573
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZMT-04760P225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty