Business Name
Physician First Name
Mary
Physician Middle Initial
Frances
Physician Last Name
Fredenberg
Practice Name
Specialty
Dermatology
Office Designation
Primary
Address
14155 N 83rd Ave
85381
85381
Suite
Suite 110
City
Peoria
State
AZ
County
Maricopa
Business Phone Number
(623)215-0911
Business Fax
(623)215-0912
ASPA Effective Date
11/9/1987
Business Name
Physician First Name
Theresa
Physician Middle Initial
T.
Physician Last Name
Magne
Practice Name
Specialty
Dermatology
Office Designation
Primary
Address
14155 N 83rd Ave
85381
85381
Suite
Suite 110
City
Peoria
State
AZ
County
Maricopa
Business Phone Number
(623)215-0911
Business Fax
(623)215-0912
ASPA Effective Date
11/6/1995
Business Name
Physician First Name
Adam
Physician Middle Initial
Thomas
Physician Last Name
Sorensen
Practice Name
Specialty
Dermatology
Office Designation
Primary
Address
14155 N 83rd Ave
85381
85381
Suite
Suite 110
City
Peoria
State
AZ
County
Maricopa
Business Phone Number
(623)215-0911
Business Fax
(623)215-0912
ASPA Effective Date
8/3/2015
Business Name
Physician First Name
Douglas
Physician Middle Initial
James
Physician Last Name
Heiner
Practice Name
Specialty
Dermatology
Office Designation
Primary
Address
14155 N 83rd Ave
85381
85381
Suite
Suite 110
City
Peoria
State
AZ
County
Maricopa
Business Phone Number
(623)215-0911
Business Fax
(623)215-0912
ASPA Effective Date
7/6/2015
Business Name
Physician First Name
Lisa
Physician Middle Initial
Mary
Physician Last Name
Greenan
Practice Name
Specialty
Physician Assistant
Office Designation
Primary
Address
14155 N. 83rd Avenue
85381
85381
Suite
Suite 110
City
Peoria
State
AZ
County
Maricopa
Business Phone Number
(623)215-0911
Business Fax
(623)215-0912
ASPA Effective Date
12/3/2018
Business Name
Physician First Name
Elizabeth
Physician Middle Initial
Ann
Physician Last Name
Penfold
Practice Name
Specialty
Physician Assistant
Office Designation
Primary
Address
14155 N. 83rd Avenue
85381
85381
Suite
Suite 110
City
Peoria
State
AZ
County
Maricopa
Business Phone Number
(623)215-0911
Business Fax
(623)215-0912
ASPA Effective Date
11/5/2018
Business Name
Physician First Name
Julie
Physician Middle Initial
Lynn
Physician Last Name
Taubert
Practice Name
Specialty
Physician Assistant
Office Designation
Primary
Address
14155 N. 83rd Avenue
85381
85381
Suite
Suite 110
City
Peoria
State
AZ
County
Maricopa
Business Phone Number
(623)215-0911
Business Fax
(623)215-0912
ASPA Effective Date
11/5/2018
Business Name
Physician First Name
Haley
Physician Middle Initial
E.
Physician Last Name
Meier
Practice Name
Specialty
Physician Assistant
Office Designation
Primary
Address
14155 N. 83rd Avenue
85381
85381
Suite
Suite 110
City
Peoria
State
AZ
County
Maricopa
Business Phone Number
(623)215-0911
Business Fax
(623)215-0912
ASPA Effective Date
11/5/2018