| NPI | 1043701543 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAWN VIGNEAU Member 480-556-9755 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP3300X Clinic/Center, Pain |
| Additional Taxonomies | 208600000X Surgery |
| 261QA1903X Clinic/Center, Ambulatory Surgical | |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| Enumeration Date | 2018-05-21 |
| Last Update Date | 2019-02-04 |