| NPI | 1023305836 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DWAYNE DOUGLAS GBELIA Owner 480-620-4498 |
| Organization Subpart ? | No |
| Primary Taxonomy | 246ZC0007X Specialist/Technologist, Other, Surgical Assistant (Licence: AZ 09-137) |
| Enumeration Date | 2011-06-30 |
| Last Update Date | 2011-06-30 |