| NPI | 1053072504 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL VASILIAUSKAS VP Business Development 602-971-6950 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2022-01-06 |
| Last Update Date | 2022-01-11 |