| NPI | 1063408649 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AZAM S. KHAN Chief Administrative Officer 928-757-3636 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: AZ OSC0074) |
| Enumeration Date | 2005-09-20 |
| Last Update Date | 2018-06-04 |