| NPI | 1053421057 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAYE AVARANN CUNNINGHAM Attending Physician 928-768-2558 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AZ Z8326) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A71438) |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2020-08-22 |