Individual
LAURA MANIGO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C, MMS
Contact information
Practice address
6135 N 35TH AVE STE 117, PHOENIX, AZ 85017-1951
(480) 677-8282
Mailing address
261 N ROOSEVELT AVE, CHANDLER, AZ 85226-2617
(480) 677-8282
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
9672
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
169141
—
AZ
Enumeration date
08/11/2009
Last updated
02/13/2025
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