| NPI | 1003996224 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GERALD C WEST Owner 928-788-9378 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: AZ 27671) |
| Enumeration Date | 2006-10-16 |
| Last Update Date | 2011-02-02 |