| NPI | 1114301157 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DINNORAH MILLAN MEDINA Family Nurse Practitioner 520-256-7534 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) (Licence: AZ rn131609) |
| Enumeration Date | 2015-07-18 |
| Last Update Date | 2015-07-18 |