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Organization
SIERRA BLANCA CLINIC, LTD.
Active
Organization
SIERRA BLANCA CLINIC, LTD.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK MITCHELL GARSKOF MD (PRESIDENT)
(928) 368-0765
Entity
Organization
Contact information
Practice address
2963 W WHITE MOUNTAIN BLVD, LAKESIDE, AZ 85929-6257
(928) 368-0765
Mailing address
PO BOX 1210, LAKESIDE, AZ 85929-1210
(928) 368-0765
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
10885
AZ
Other
Enumeration date
10/04/2007
Last updated
12/27/2016
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