| NPI | 1164459343 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON C ALLEN Sole Member 928-753-4500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist Foot & Ankle Surgery (Licence: AZ 0641) |
| Enumeration Date | 2006-06-26 |
| Last Update Date | 2014-04-27 |