| NPI | 1053762674 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRANDON SCOTT MAGILL Owner 928-965-2840 |
| Organization Subpart ? | No |
| Primary Taxonomy | 246ZC0007X Specialist/Technologist, Other, Surgical Assistant |
| Enumeration Date | 2016-06-24 |
| Last Update Date | 2016-06-24 |