| NPI | 1205509510 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WENDY BRYANT CEO 480-500-8065 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care |
| Additional Taxonomies | 291U00000X Clinical Medical Laboratory |
| Enumeration Date | 2021-08-01 |
| Last Update Date | 2025-08-18 |