Individual
DORA MADRIGAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6842 N 78TH AVE, GLENDALE, AZ 85303-2900
(602) 653-9034
Mailing address
6842 N 78TH AVE, GLENDALE, AZ 85303
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LP044086
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LP044086
SPECIALIST
AZ
Enumeration date
09/23/2015
Last updated
09/23/2015
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