| NPI | 1194980540 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY RYAN BRADFORD Owner 480-963-5832 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: AZ 7935) |
| Enumeration Date | 2008-07-25 |
| Last Update Date | 2009-03-05 |