Organization
PVIM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALLYSON K MORGAN (OFFICE MANAGER)
(602) 695-7392
Entity
Organization
Contact information
Practice address
4494 W PEORIA AVE, SUITE 115A, GLENDALE, AZ 85302-2023
(623) 878-5800
(623) 773-2274
Mailing address
4494 W PEORIA AVE, SUITE 115A, GLENDALE, AZ 85302-2023
(623) 878-5800
(623) 773-2274
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
10/21/2015
Last updated
10/21/2015
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