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General NPI Number Information
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NPI Number | 1649967589
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Entity Type | Organization
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Legal Business Name | TDM MEDICAL STAFFING AGENCY PLLC
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Dates
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Enumeration Date | 04/20/2023
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Last Update Date | 05/18/2023
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Provider Practice Location Address
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Address Line | 2406 S 24TH STREET STE 216
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City | PHOENIX
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State | AZ
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Zip | 85034
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Country | US
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Telephone | 623-521-8325
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Fax | 623-000-0000
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Provider Business Mailing Address
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Address Line | 2228 S 238TH LN
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City | BUCKEYE
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State | AZ
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Zip | 85326-3609
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Country | US
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Telephone | 623-521-8325
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Fax | 623-000-0000
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Authorized Official
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Title or Position | OWNER
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Name | TRISCHELLA MOORE
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Credential |
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Telephone | 623-521-8325
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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