# TLC FAMILY MEDICINE PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1174573489
- **Authorized official:** DR. ANTHONY MANNINO DO (PRESIDENT CEO)
- **Authorized official phone:** (480) 598-1357

## Contact information

- **Practice address:** 16515 S 40TH ST, SUITE 131, PHOENIX, AZ 85048-0558
- **Practice address phone:** (480) 598-1357
- **Practice address fax:** (480) 598-3070
- **Mailing address:** 16515 S 40TH ST, SUITE 131, PHOENIX, AZ 85048-0558
- **Mailing address phone:** (480) 598-1357
- **Mailing address fax:** (480) 598-3070

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 363A00000X | Physician Assistant | — | NULL | — |
| 363A00000X | Physician Assistant | — | — | — |

## Other

- **Enumeration date:** 05/10/2006
- **Last updated:** 10/10/2007