Organization
MANA VASCULAR CLINIC, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LANNERY SIOELI LAUVAO MD (OWNER)
(520) 979-7095
Entity
Organization
Contact information
Practice address
18555 N 79TH AVE STE B101, GLENDALE, AZ 85308-8372
(520) 979-7095
(623) 594-2252
Mailing address
14780 W MOUNTAIN VIEW BLVD STE 120, SURPRISE, AZ 85374-7280
(520) 979-7095
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
Other
Enumeration date
07/20/2018
Last updated
08/11/2024
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