Provider Demographics
NPI:1760545438
Name:SYNERGY PEDIATRIC THERAPY
Entity Type:Organization
Organization Name:SYNERGY PEDIATRIC THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MELANIE
Authorized Official - Middle Name:IRENE
Authorized Official - Last Name:CONATSER
Authorized Official - Suffix:
Authorized Official - Credentials:OTRL
Authorized Official - Phone:480-247-2833
Mailing Address - Street 1:835 W WARNER RD
Mailing Address - Street 2:SUITE 101-473
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85233-7269
Mailing Address - Country:US
Mailing Address - Phone:480-247-2833
Mailing Address - Fax:480-247-2833
Practice Address - Street 1:835 W WARNER RD
Practice Address - Street 2:SUITE 101-473
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85233-7269
Practice Address - Country:US
Practice Address - Phone:480-247-2833
Practice Address - Fax:480-247-2833
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health