NPI | 1023073525 |
---|---|
Entity Type | Organization |
Authorized Contact | CHRISTY HADEN CEO 520-508-7829 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty |
Additional Taxonomies | 332900000X Non-Pharmacy Dispensing Site |
Enumeration Date | 2006-04-18 |
Last Update Date | 2025-05-07 |