Provider Demographics
NPI:1679036800
Name:GMCLARTY ENTERPRISES LLC
Entity type:Organization
Organization Name:GMCLARTY ENTERPRISES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:A
Authorized Official - Last Name:MCLARTY
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT
Authorized Official - Phone:480-227-5639
Mailing Address - Street 1:36902 N ALEUTIAN DR
Mailing Address - Street 2:
Mailing Address - City:SAN TAN VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85143-1469
Mailing Address - Country:US
Mailing Address - Phone:480-474-4921
Mailing Address - Fax:480-447-4983
Practice Address - Street 1:2140 E 5TH ST STE 8
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85288-3043
Practice Address - Country:US
Practice Address - Phone:480-474-4921
Practice Address - Fax:480-447-4983
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-14
Last Update Date:2025-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy