| NPI | 1164064929 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON LEE MUSSMAN CEO/Sole Member 623-243-9077 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2019-10-14 |
| Last Update Date | 2019-10-14 |