| NPI | 1023381555 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON HEAVENS President 480-399-6440 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2012-02-14 |
| Last Update Date | 2025-04-30 |