| NPI | 1154675239 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VIRGENE J UGWU Office Manager 928-337-3125 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: AZ 7695) |
| Enumeration Date | 2012-10-29 |
| Last Update Date | 2026-06-01 |