Organization
SKIN CONCIERGE, LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DESTINY GYPSYLEE MATTOX (PRACTICE MANAGER)
(520) 333-5973
Entity
Organization
Contact information
Practice address
1310 W. ST. MARY'S ROAD, 2ND FLOOR, SUITE A, TUCSON, AZ 85745
(520) 333-5973
(520) 221-2318
Mailing address
1310 W SAINT MARYS RD STE A, TUCSON, AZ 85745-3231
(520) 333-5973
(520) 221-2318
Taxonomy
Speciality
Code
Description
License number
State
207NI0002X
Clinical & Laboratory Dermatological Immunology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
162831
—
AZ
Enumeration date
08/09/2017
Last updated
03/30/2023
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