Organization
ANTHRACITE MEDICAL PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH LEONARD VICCICA (MEMBER)
(570) 299-0037
Entity
Organization
Contact information
Practice address
4855 BUTTERFLY DR, PRESCOTT, AZ 86301-5770
(570) 299-0037
Mailing address
4855 BUTTERFLY DR, PRESCOTT, AZ 86301-5770
(570) 299-0037
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
02/08/2024
Last updated
02/12/2024
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