| NPI | 1174084982 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRANCE WADE O'NEAL Owner/Partner 623-764-2780 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2019-03-26 |
| Last Update Date | 2019-03-26 |