| NPI | 1003423609 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TINA MANKIN Administrator/Director Of Nursing 602-510-3203 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Additional Taxonomies | 207XX0005X Orthopaedic Surgery, Sports Medicine |
| Enumeration Date | 2020-09-28 |
| Last Update Date | 2020-09-28 |