| NPI | 1114320405 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYNN COOPER JOHNSON Owner 928-243-1770 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AZ AP5735) |
| Enumeration Date | 2014-10-01 |
| Last Update Date | 2014-10-01 |