| Tlc Family Medicine Pc | |
|
16515 S 40th St Suite 131 Phoenix AZ 85048-0558 | |
| (480) 598-1357 | |
| (480) 598-3070 |
| Full Name | Tlc Family Medicine Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 16515 S 40th St, Phoenix, Arizona |
| Authorized Official Name and Position | Anthony Mannino (PRESIDENT CEO) |
| Authorized Official Contact | 4805981357 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tlc Family Medicine Pc 16515 S 40th St Suite 131 Phoenix AZ 85048-0558 Ph: (480) 598-1357 | Tlc Family Medicine Pc 16515 S 40th St Suite 131 Phoenix AZ 85048-0558 Ph: (480) 598-1357 |
| NPI Number | 1174573489 |
|---|---|
| Provider Enumeration Date | 05/10/2006 |
| Last Update Date | 10/10/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174573489 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 363A00000X | Physician Assistant | (* (Not Available)) | Secondary |
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