| NPI | 1144860800 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURA GOLD Owner 602-703-7275 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 261QH0100X Clinic/Center Health Service |
| 261QP2300X Clinic/Center Primary Care | |
| 261QP3300X Clinic/Center Pain | |
| Enumeration Date | 2020-01-10 |
| Last Update Date | 2020-02-05 |