| NPI | 1154378909 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN NOVAK Director 928-214-2700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: AZ OSC 2303) |
| Enumeration Date | 2006-05-27 |
| Last Update Date | 2010-06-11 |