NPI | 1114171436 |
---|---|
Entity Type | Organization |
Authorized Contact | SHAWN LEE Chief Operating Offier 928-289-2650 |
Organization Subpart ? | No |
Primary Taxonomy | 251S00000X (Licence: AZ CSLG5954) |
Additional Taxonomies | 251S00000X (Licence: AZ CSLG7215) |
Enumeration Date | 2008-11-13 |
Last Update Date | 2021-07-26 |