| NPI | 1144910761 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTOINETTE BOYD Owner 623-385-2288 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 251S00000X |
| 261Q00000X Clinic/Center | |
| Enumeration Date | 2023-05-08 |
| Last Update Date | 2023-05-08 |