SOUTHWEST SKIN & CANCER INSTITUTE LTD
Osteopathic Medicine at Whipple St, Prescott, AZ

License number
Arizona 31062
Category
Osteopathic Medicine
Type
Dermatopathology
Owner
Name: DR. ROBIN M FLECK MD
Title: OWNER/SOLE MEMBER
Phone: (928) 778-0808
Address
Address
242 Whipple St, Prescott, AZ 86301
National Provider ID: 1427428416
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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SOUTHWEST SKIN & CANCER INSTITUTE, LTD

Prescott, AZ

Status:
Inactive
Industry:
Specialty Hospital
Registration:
Jan 15, 2004
Addresses:
242 Whipple St #1, Prescott, AZ 86301 (Physical)
1590 Willow Crk Rd, Prescott, AZ 86301
State ID:
-1113050-7
Expiration:
PERPETUAL
Administrations:
Robin M Fleck Md (President), 242 Whipple St STE 1, Prescott, AZ 86301 (Physical),Robin M Fleck Secretary, Dermatology, President, inactive, 242 Whipple St STE 1, Prescott, AZ 86301 (Physical),Jan K. Gillum Office Manager, inactive,...

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