| NPI | 1114586542 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUSTIN THOMAS PEPPERLING CEO 928-255-3420 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 261QU0200X Clinic/Center, Urgent Care |
| Enumeration Date | 2019-06-10 |
| Last Update Date | 2020-06-09 |