| NPI | 1003874280 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN P TRIPP Owner 480-830-7546 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: AZ 4321) |
| Enumeration Date | 2006-05-04 |
| Last Update Date | 2010-12-08 |