| NPI | 1013151489 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL WILLIAM RAE Medical Director/Owner 480-390-1962 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0400X Clinic/Center, Rehabilitation (Licence: AZ 8028) |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care (Licence: AZ 8028) |
| Enumeration Date | 2009-04-28 |
| Last Update Date | 2009-04-28 |