Provider Demographics
NPI:1326268335
Name:GORGOL, ESTHER C
Entity Type:Individual
Prefix:MRS
First Name:ESTHER
Middle Name:C
Last Name:GORGOL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10786 E TERRA DR
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258-6144
Mailing Address - Country:US
Mailing Address - Phone:480-391-3331
Mailing Address - Fax:
Practice Address - Street 1:16000 E PALISADES BLVD
Practice Address - Street 2:
Practice Address - City:FOUNTAIN HILLS
Practice Address - State:AZ
Practice Address - Zip Code:85268-3131
Practice Address - Country:US
Practice Address - Phone:480-664-5000
Practice Address - Fax:480-664-5097
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ30962251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics