| NPI | 1053635599 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS B GRANADO Executive Director 480-722-2730 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: AZ OTC5864) |
| Additional Taxonomies | 251S00000X (Licence: AZ BH-3702) |
| 251S00000X (Licence: AZ BH-3558) | |
| Enumeration Date | 2010-03-25 |
| Last Update Date | 2023-10-06 |