| NPI | 1073803508 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MIKEL WILLARD SKOUSEN Physician 480-833-5383 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: AZ 1213) |
| Enumeration Date | 2011-04-18 |
| Last Update Date | 2011-09-09 |