| NPI | 1033302195 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COLLEEN J SPEIDELL Owner 928-317-2707 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AZ RN084306) |
| Enumeration Date | 2007-08-22 |
| Last Update Date | 2010-01-22 |