Ketamine Wellness Centers Mesa, LLC

NPI #1447811898 in Gilbert, Arizona

Provider Information

NPI Number: 1447811898
Entity Type: Organization
Organization Name: Ketamine Wellness Centers Mesa, LLC
Primary Specialty: Anesthesiology
Enumeration Date: Jun 26, 2019
Last Updated: Jan 10, 2022

Practice Location

Address: 2451 E BASELINE RD STE 300
City: Gilbert
State: Arizona
ZIP Code: 85234-2465
Phone: (480) 788-8539

Authorized Official

Name: MS. ANITA D JERGER
Title: EXECUTIVE ASSISTANT
Phone: (855) 538-9355

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Registered Nurse	163W00000X
Pain Medicine - Pain Medicine — Pain Medicine	208VP0000X
Pain Medicine - Interventional Pain Medicine — Interventional Pain Medicine	208VP0014X
Physician Assistant	363A00000X
Anesthesiology	207L00000X	Primary

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