AHWATUKEE SKIN & LASER LLC
Osteopathic Medicine at Agave Rd, Phoenix, AZ

License number
Arizona 15963
Category
Osteopathic Medicine
Type
Dermatopathology
Owner
Name: SARAH E NEUMANN PA-C
Title: MANAGER, PROVIDER
Phone: (480) 704-7546
Address
Address
4425 E Agave Rd SUITE 148, Phoenix, AZ 85044
National Provider ID: 1407167596
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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AHWATUKEE SKIN & LASER, LLC

4425 E Agave Rd STE 148, Phoenix, AZ 85044

Industry:
Medical Doctor's Office
Doing business as:
Asl
Registration:
Jun 8, 2010
State ID:
L-1607969-9
Expiration:
Perpetual
Mbr , Principals:
Duane C Whitaker (Member, Dermatology, Medical Doctor), 4425 E Agave Rd STE 148, Phoenix, AZ 85044 (Physical),Sarah Neumann Revocable Trust (Member), 4425 E Agave Rd STE 148, Phoenix, AZ 85044 (Physical),Sarah E. Neumann (Manager, Managing Member, Physician Assistant),...
Agent:
Sarah Neumann,4425 E Agave Rd STE 148, Phoenix, AZ 85044 (Physical)

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