Organization
NO ARIZ DERMATOLOGY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CYNTHIA ACKERMANN KNUTSON MD (CEO)
(928) 774-5074
Entity
Organization
Contact information
Practice address
297 S WILLARD ST, COTTONWOOD, AZ 86326
(928) 639-9596
(928) 639-0189
Mailing address
1490 N TURQUOISE DR, SAA, FLAGSTAFF, AZ 86001
(928) 774-5074
(928) 779-0884
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0301000963
CLIA
AZ
Enumeration date
02/21/2007
Last updated
08/22/2020
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