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Organization
TLC FAMILY MEDICINE PC
Active
Organization
TLC FAMILY MEDICINE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANTHONY MANNINO DO (PRESIDENT CEO)
(480) 598-1357
Entity
Organization
Contact information
Practice address
16515 S 40TH ST, SUITE 131, PHOENIX, AZ 85048-0558
(480) 598-1357
(480) 598-3070
Mailing address
16515 S 40TH ST, SUITE 131, PHOENIX, AZ 85048-0558
(480) 598-1357
(480) 598-3070
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
363A00000X
Physician Assistant
—
NULL
363A00000X
Physician Assistant
—
—
Other
Enumeration date
05/10/2006
Last updated
10/10/2007
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