Organization
MANZANITA MEDICAL PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUDITH HALLAS (OFFICE MANAGER)
(480) 292-9532
Entity
Organization
Contact information
Practice address
4545 E SHEA BLVD STE 130, PHOENIX, AZ 85028-3061
(480) 292-9532
(480) 664-3482
Mailing address
4545 E SHEA BLVD STE 130, PHOENIX, AZ 85028-3061
(480) 292-9532
(480) 664-3482
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
AZ
Other
Enumeration date
06/19/2017
Last updated
07/23/2024
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