| NPI | 1013121458 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RHONDA LARSON Director 480-226-5497 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center Multi-Specialty (Licence: AZ TBD) |
| Enumeration Date | 2007-05-09 |
| Last Update Date | 2020-08-22 |