| NPI | 1164715421 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER KELSCH Manager 602-889-5833 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 111N00000X Chiropractor |
| 132700000X Dietary Manager | |
| 171M00000X Case Manager/Care Coordinator | |
| 111NR0400X | |
| Enumeration Date | 2011-05-19 |
| Last Update Date | 2012-03-23 |