NPI | 1013068642 |
---|---|
Entity Type | Organization |
Authorized Contact | ERIC BOON Officer / Authorized Official 480-567-0269 |
Organization Subpart ? | No |
Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: CA 550000544) |
Enumeration Date | 2007-01-12 |
Last Update Date | 2024-12-04 |