BLACK CANYON MEDICAL

SPRING VALLEY, AZ
NPI1972799856
Doing Business AsBRADSHAW MOUNTAIN FAMILY MEDICINE
Entity TypeOrganization
Authorized ContactRANDY CHARLES HANCOCK
Owner
623-742-6428
Organization Subpart ?No
Primary Taxonomy207K00000X Allergy & Immunology
(Licence: AZ  3297)
Enumeration Date2007-09-24
Last Update Date2007-09-24
Business Address
BLACK CANYON MEDICAL
17301 E SPRING VALLEY RD STE F
SPRING VALLEY, AZ 86333-4263
Phone number: 928-632-4909
Mailing Address
BLACK CANYON MEDICAL
46641 N BLACK CANYON HWY STE 5
NEW RIVER, AZ 85087-6941
Phone number: 623-742-6428