# SKIN CONCIERGE, LLC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1497270664
- **Authorized official:** DESTINY GYPSYLEE MATTOX (PRACTICE MANAGER)
- **Authorized official phone:** (520) 333-5973

## Contact information

- **Practice address:** 1310 W. ST. MARY'S ROAD, 2ND FLOOR, SUITE A, TUCSON, AZ 85745
- **Practice address phone:** (520) 333-5973
- **Practice address fax:** (520) 221-2318
- **Mailing address:** 1310 W SAINT MARYS RD STE A, TUCSON, AZ 85745-3231
- **Mailing address phone:** (520) 333-5973
- **Mailing address fax:** (520) 221-2318

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207NI0002X | Clinical & Laboratory Dermatological Immunology Physician | — | NULL | Yes |
| 207NI0002X | Clinical & Laboratory Dermatological Immunology Physician | — | — | Yes |

## Other

- **Enumeration date:** 08/09/2017
- **Last updated:** 03/30/2023