| NPI | 1043544802 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RANDOLPH MARSHALL HOWARD President 480-497-3245 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: AZ L15454205) |
| Enumeration Date | 2009-09-28 |
| Last Update Date | 2009-09-28 |