Organization
ACTIVE KIDS PEDIATRICS, PC
Active
Organization
ACTIVE KIDS PEDIATRICS, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JUDITH ROSCH BARNES CLARK M.D. (PEDIATRICIAN, CO-OWNER)
(480) 783-8960
Entity
Organization
Contact information
Practice address
15215 S 48TH ST, SUITE 110, PHOENIX, AZ 85044-9142
(480) 783-8960
(480) 783-8967
Mailing address
15215 S 48TH ST, SUITE 110, PHOENIX, AZ 85044-9142
(480) 783-8960
(480) 783-8967
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
A32674
AZ
Other
Enumeration date
08/13/2012
Last updated
08/13/2012
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