| NPI | 1154474310 |
|---|---|
| Other Name | JESSE OWENS URGENT CARE |
| Entity Type | Organization |
| Authorized Contact | CARLENE E DANIS CEO 602-824-4640 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QU0200X Clinic/Center, Urgent Care (Licence: AZ OTC0106) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AZ 29250) |
| 208000000X Pediatrics (Licence: AZ 2816) | |
| Enumeration Date | 2007-01-19 |
| Last Update Date | 2013-02-19 |