Individual
TANA A WILLIAMS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6955 W STATE AVE, GLENDALE, AZ 85303-2172
(623) 329-6442
Mailing address
6955 W STATE AVE, GLENDALE, AZ 85303-2172
(623) 329-6442
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
ALH-6703
AZ
Other
Enumeration date
06/25/2008
Last updated
06/25/2008
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