Triad Clinic Pllc | |
4902 W Ironwood Dr Glendale AZ 85302-2402 | |
(602) 667-4636 | |
(480) 247-5551 |
Full Name | Triad Clinic Pllc |
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Speciality | Nurse Practitioner - Family |
Location | 4902 W Ironwood Dr, Glendale, Arizona |
Authorized Official Name and Position | Daniel Knight (PRESIDENT) |
Authorized Official Contact | 6026674636 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Triad Clinic Pllc 5350 W Bell Rd Suite C-122-417 Glendale AZ 85308-3906 Ph: (602) 667-4636 | Triad Clinic Pllc 4902 W Ironwood Dr Glendale AZ 85302-2402 Ph: (602) 667-4636 |
NPI Number | 1174857791 |
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Provider Enumeration Date | 09/29/2009 |
Last Update Date | 11/04/2010 |
Identifier | Type | State | Issuer |
---|---|---|---|
1174857791 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208D00000X | General Practice | 3175 (Arizona) | Secondary |
363LF0000X | Nurse Practitioner - Family | AP2115 (Arizona) | Primary |
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