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Individual

LIANI KELLY MCCLINE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
10815 W MCDOWELL RD STE 301, AVONDALE, AZ 85392-5016
(623) 535-0740
(623) 512-4460
Mailing address
PO BOX 748860, ATLANTA, GA 30374
(623) 535-0740

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
TP8091
AZ
363A00000X
Physician Assistant
Primary

Other

Enumeration date
04/10/2020
Last updated
06/26/2023
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