| NPI | 1104681915 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HILARY NGUYEN Owner 602-326-7460 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 261QH0100X Clinic/Center, Health Services |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| Enumeration Date | 2024-02-20 |
| Last Update Date | 2024-02-20 |