Organization
INNOVATIVE DERMATOLOGY ALLIANCE AZ, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTOPHER U REX MD (OWNER)
(904) 994-4533
Entity
Organization
Contact information
Practice address
390 BRALLIAR RD, WICKENBURG, AZ 85390
(602) 971-0268
Mailing address
3318 W LUCIA DR, PHOENIX, AZ 85083-5884
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Enumeration date
05/11/2020
Last updated
11/27/2023
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