Individual
TIMOTHY AARON LAMANNA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
5777 E MAYO BLVD, PHOENIX, AZ 85054-4502
(480) 342-2000
Mailing address
2901 N CENTRAL AVE, STE 160, PHOENIX, AZ 85012-2702
(480) 301-8000
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5242
AZ
363AM0700X
Medical Physician Assistant
5242
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1548511082
—
AZ
Enumeration date
09/24/2012
Last updated
07/21/2022
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