| Triad Clinic Pllc | |
|
4902 W Ironwood Dr Glendale AZ 85302-2402 | |
| (602) 667-4636 | |
| (480) 247-5551 |
| Full Name | Triad Clinic Pllc |
|---|---|
| Speciality | Nurse Practitioner - Family |
| Location | 4902 W Ironwood Dr, Glendale, Arizona |
| Authorized Official Name and Position | Daniel Knight (PRESIDENT) |
| Authorized Official Contact | 6026674636 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Triad Clinic Pllc 5350 W Bell Rd Suite C-122-417 Glendale AZ 85308-3906 Ph: (602) 667-4636 | Triad Clinic Pllc 4902 W Ironwood Dr Glendale AZ 85302-2402 Ph: (602) 667-4636 |
| NPI Number | 1174857791 |
|---|---|
| Provider Enumeration Date | 09/29/2009 |
| Last Update Date | 11/04/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174857791 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | 3175 (Arizona) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | AP2115 (Arizona) | Primary |
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