Organization · NPI-2

Active Lifestyle Medical PC

Clinic/Center · Scottsdale, AZ

NPI number1013970334
StatusActive
Last updated in NPPESFeb 8, 2015

Details

NPI
1013970334
Entity type
Organization (NPI-2)
Legal business name
Active Lifestyle Medical PC
Organization subpart
No
Enumeration date
Apr 8, 2006
Last updated
Feb 8, 2015

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
261Q00000X Clinic/Center000000000928481AZYes

Practice location

9449 N 90th St
Ste 114
Scottsdale, AZ 85258-5099

Phone 480-860-0300 · Fax 480-422-4321

Mailing address

9449 N 90th St
Ste 114
Scottsdale, AZ 85258-5099

Phone 480-860-0300 · Fax 480-422-4321

Authorized official

Thomas L Tinlin
President Senior Clinician
4808600300

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