GREATER PHOENIX COLLABORATIVE CARE, PC
Ambulatory Health at 19 Ave, Phoenix, AZ

License number
Arizona OTC 4998
Category
Ambulatory Health
Type
Clinic/Center
Owner
Name: THOMAS CHEEK MD
Title: MEDICAL DIRECTOR
Phone: (702) 579-3253
Address
Address 2
6036 N 19Th Ave SUITE 402, Phoenix, AZ 85015
35380 Medical Staff- Credentialing Dept., Las Vegas, NV 89133
National Provider ID: 1750686614
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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"GREATER PHOENIX COLLABORATIVE CARE, P.C."

20414 N 27 Ave, Phoenix, AZ 85027

Industry:
Health/Allied Services
Doing business as:
Greater Phoenix Collaborative Care, PC<br>Lifeprint Care Center
Registration:
Mar 30, 2010
State ID:
-1593436-8
Expiration:
PERPETUAL
Nurse Practitioners:
Michelle Marie Huntley Dill (Other officer), 9900 Bren Rd E, Hopkins, MN 55343 (Physical),Brian Riveland (President), 6992 W Melinda Ln, Glendale, AZ 85308 (Physical),Michael John Dioguardi (Secretary), 1331 17 St SUITE 1100, Denver, CO 80202 (Physical),...
Agent:
Ct Corporation System,2390 E Camelback Rd, Phoenix, AZ 85016 (Physical)

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