| NPI | 1093085904 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BOON ERIC Officer/Authorized Official 480-567-0269 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center Ambulatory Surgical |
| Enumeration Date | 2012-01-09 |
| Last Update Date | 2024-10-04 |