| NPI | 1023311743 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MIKE RENAUD CEO 602-258-6797 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: AZ OTC6049) |
| Additional Taxonomies | 251S00000X (Licence: AZ OTC-6049) |
| Enumeration Date | 2010-12-20 |
| Last Update Date | 2024-06-07 |