| NPI | 1124765003 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID NYE Owner / Founder 480-788-5621 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0129X |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2022-05-12 |
| Last Update Date | 2022-05-12 |