| NPI | 1205039666 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER JANE FONTIUS Owner 602-516-5244 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: AZ 35692) |
| Enumeration Date | 2007-06-05 |
| Last Update Date | 2015-03-04 |