CHILDRENS MEDICAL CENTER OF BULLHEAD CITY, PLLC
Medical Practice in Bullhead City, AZ

License number
Arizona 31594
Category
Medical Practice
Type
Pediatrics
Owner
Name: NAILA ASHRAF TARIQ M.D.
Title: PHYSICIAN
Phone: (928) 758-0183
Address
Address
1225 Hancock Rd Suite #B, Bullhead City, AZ 86442
National Provider ID: 1063510279
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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CHILDREN'S MEDICAL CENTER OF BULLHEAD CITY, PLLC

Bullhead City, AZ

Status:
Inactive
Industry:
Medical Doctor's Office
Registration:
Jan 30, 2001
Addresses:
5599 Clubhouse Dr, Fort Mohave, AZ 86426 (Physical)
5599 S Clb House Dr, Bullhead City, AZ 86426
State ID:
P-0977399-0
Expiration:
Perpetual
Manager, Principals:
Naila A Tariq (Manager), 5599 Clubhouse Dr, Fort Mohave, AZ 86426 (Physical),Mohammad Tariq Manager, Principal, inactive, 5599 Clubhouse Dr, Fort Mohave, AZ 86426 (Physical)
Agent:
Naila Tariq,5599 Clubhouse Dr, Fort Mohave, AZ 86426 (Physical)

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