| NPI | 1013151604 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MYRON B LICHT Owner 602-300-2793 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation |
| Enumeration Date | 2009-04-27 |
| Last Update Date | 2009-04-27 |