| NPI | 1114586542 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY A HERRING Medical Director 928-853-7876 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 261QU0200X Clinic/Center, Urgent Care | |
| Enumeration Date | 2019-06-10 |
| Last Update Date | 2025-12-03 |