Black Canyon Medical

NPI #1972799856 in Spring Valley, Arizona

Provider Information

NPI Number: 1972799856
Entity Type: Organization
Organization Name: Black Canyon Medical
Primary Specialty: Allergy & Immunology
Enumeration Date: Sep 24, 2007
Last Updated: Sep 24, 2007

Practice Location

Address: 17301 E SPRING VALLEY RD
Address 2: STE F
City: Spring Valley
State: Arizona
ZIP Code: 86333-4263
Phone: (928) 632-4909

Authorized Official

Name: DR. RANDY CHARLES HANCOCK, D.O.
Title: OWNER
Phone: (623) 742-6428

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Allergy & Immunology	207K00000X	Primary

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