| NPI | 1154498459 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURIE A THOMAS Physician 520-795-8841 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: AZ 25576) |
| Enumeration Date | 2006-11-29 |
| Last Update Date | 2020-08-22 |