| NPI | 1093182453 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SYLVIA LISA VALENZUELA Biller 623-776-2225 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine |
| Enumeration Date | 2015-09-01 |
| Last Update Date | 2015-09-01 |