BANNER PHYSICIAN SUPER SPECIALISTS ARIZONA LLC is a nutrition and education nutritionist in Glendale, AZ. BANNER PHYSICIAN SUPER SPECIALISTS ARIZONA LLC NPI is 1578125738. The provider is registered as an organization entity type and is a multiple single specialty group.
The provider's business location address is:
5310 W THUNDERBIRD RD STE 214
GLENDALE, AZ
ZIP 85306-722
Phone: (602) 865-4480
The provider's authorized official is Dennis Laraway .
The authorized official title is Cfo and has the following contact phone number (602) 747-4000.
The CLIA number assigned to this NPI record is 03D2057987 - physician office with a certificate type of Certificate of Waiver.
The enumeration date for this NPI number is 7/8/2019 and was last updated on 12/28/2021.