Organization
TAZ GLENDALE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREW M ELLIOTT (COO)
(323) 369-0069
Entity
Organization
Contact information
Practice address
5605 W EUGIE AVE, SUITE 111, GLENDALE, AZ 85304-1272
(480) 306-8195
(480) 306-8196
Mailing address
5605 W EUGIE AVE, SUITE 111, GLENDALE, AZ 85304-1272
(480) 306-8195
(480) 306-8196
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
AZ
Other
Enumeration date
02/02/2016
Last updated
06/07/2016
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