| NPI | 1114109642 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDSEY VANDEPOL Office Manager 480-661-8348 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: AZ 21407) |
| Enumeration Date | 2007-11-27 |
| Last Update Date | 2021-02-03 |