Individual
MARK CREEK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
R.N.
Contact information
Practice address
HWY 12 AND HWY 17, FT. DEFIANCE, AZ 86504-4039
(928) 729-8882
Mailing address
3388 E LOCKETT RD, FLAGSTAFF, AZ 86004-4039
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
145267
AZ
Other
Enumeration date
01/24/2012
Last updated
01/24/2012
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