| NPI | 1023284072 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERESA BLATT Office Manager 623-878-0882 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: AZ d4955) |
| Enumeration Date | 2008-04-30 |
| Last Update Date | 2008-04-30 |