Provider Demographics
NPI:1114163599
Name:GTL PROPERTIES LLC
Entity Type:Organization
Organization Name:GTL PROPERTIES LLC
Other - Org Name:LAY CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DR. OF CHIROPRACTIC
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:MAE
Authorized Official - Last Name:KESZLER
Authorized Official - Suffix:
Authorized Official - Credentials:BSC DC
Authorized Official - Phone:520-579-2424
Mailing Address - Street 1:3605 W CORTARO FARMS RD
Mailing Address - Street 2:STE 145
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85742-8683
Mailing Address - Country:US
Mailing Address - Phone:520-579-2424
Mailing Address - Fax:520-579-2426
Practice Address - Street 1:3605 W CORTARO FARMS RD
Practice Address - Street 2:STE 145
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85742-8683
Practice Address - Country:US
Practice Address - Phone:520-579-2424
Practice Address - Fax:520-579-2426
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-06
Last Update Date:2009-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7387261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ74856Medicare PIN