| NPI | 1053698027 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACY HANKINS Owner 928-854-5400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: AZ 27481) |
| Enumeration Date | 2011-11-04 |
| Last Update Date | 2013-09-10 |