Physician Skin Solutions

NPI 1225416456 - Dermatology - 207N00000X

NPI Details
NPI 1225416456
Enumeration Date 05/07/2015
Last Updated 05/07/2015
Entity Type Healthcare Provider
Active Over 1 year ago
Authorized Information
Name SHANNON LEAH SHANNON
Position CEO/MEDICAL DIRECTOR
Phone (602) 843-4040
Fax (602) 843-4077
Practice Location
18275 N 59TH AVE
SUITE C-116
GLENDALE AZ, 85308-1260, US
Phone (602) 843-4040
Fax (602) 843-4077
Business Location
18275 N 59TH AVE
SUITE C-116
GLENDALE AZ, 85308-1260, US
Phone (602) 843-4040
Fax (602) 843-4077
Toxanomy
Taxonomy Code 207N00000X
License State Arizona
License Number 04-805
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According to our database, Physician Skin Solutions NPI is 1225416456, taxonomy code is 207N00000X and license number is 04-805, license state is located at Arizona. Physician Skin Solutions physically located at 18275 N 59th Ave, Glendale AZ, 85308-1260. NPI Number 1033115704 has the healthcare provider type.

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1225416456 NPI number is provided on an as is basis without warranty of any kind. 1225416456 is maintained by the National Plan & Provider Enumeration System. The contents of Physician Skin Solutions are for informational purposes only.