Organization
VALLEY ALLERGY AND ASTHMA CLINIC PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PRAVEENA R KOTHUR MD (PHYSICIAN/OWNER)
(602) 548-0981
Entity
Organization
Contact information
Practice address
5757 W THUNDERBIRD RD, W205, GLENDALE, AZ 85306-4641
(602) 548-0981
Mailing address
PO BOX 5148, GLENDALE, AZ 85312-5148
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
30666
AZ
Other
Enumeration date
06/01/2006
Last updated
01/03/2020
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