Organization
BLACK CANYON MEDICAL L.L.C.
Active
Other names
Malin Medical, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
KERRY D MALIN PA (PROVIDER)
(928) 710-5851
Entity
Organization
Contact information
Practice address
17301 E SPRING VALLEY RD, MAYER, AZ 86333-4263
(928) 632-4909
(928) 632-4973
Mailing address
17301 E SPRING VALLEY RD STE F, MAYER, AZ 86333-4263
(928) 710-5851
(928) 632-4973
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
3297
AZ
Other
Enumeration date
09/26/2007
Last updated
03/09/2020
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