| NPI | 1144827825 |
|---|---|
| Doing Business As | AQUAFYIV |
| Entity Type | Organization |
| Authorized Contact | SCOTT WILLIAM HORTON Medical Director And Owner 623-363-1185 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Enumeration Date | 2020-10-06 |
| Last Update Date | 2020-11-21 |