Organization
DERMATOLOGY CLINIC LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LESLIE MARY (BUSINESS MANAGER)
(602) 277-4455
Entity
Organization
Contact information
Practice address
1110 E MISSOURI AVE, 600, PHOENIX, AZ 85014-2707
(602) 277-4455
(602) 277-9654
Mailing address
1110 E MISSOURI AVE, 600, PHOENIX, AZ 85014-2707
(602) 277-4455
(602) 277-9654
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Enumeration date
08/14/2007
Last updated
11/13/2007
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