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Individual

MOLLYANN G. ALLEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
P.A.-C.

Contact information

Practice address
18185 N 83RD AVE, BLDG D, STE 107, GLENDALE, AZ 85308
(623) 583-0306
(623) 583-1349
Mailing address
8620 N 22ND AVE, 200, PHOENIX, AZ 85021-4251
(602) 674-6506
(602) 674-6512

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2167
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2167
LICENSE
AZ
05
318488
AZ
Enumeration date
04/02/2007
Last updated
08/20/2008
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