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1841342631
SHANTEL TANAE GLICK
PEORIA, AZ
NPI
1841342631
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363A00000X Physician Assistant
(Licence: AZ AZ3142)
Enumeration Date
2007-01-18
Last Update Date
2015-05-20
Business Address
-- SHANTEL TANAE GLICK PA-C
21681 N 77TH AVE
PEORIA, AZ 85382-2132
Phone number: 623-972-9200
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Mailing Address
-- SHANTEL TANAE GLICK PA-C
21681 N 77TH AVE
PEORIA, AZ 85382-2132
Phone number: 623-972-9200
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