| NPI | 1124896485 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES REYNOLDS Director 480-888-6556 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine |
| 261QI0500X Clinic/Center, Infusion Therapy | |
| Enumeration Date | 2023-12-18 |
| Last Update Date | 2023-12-18 |