NPI | 1205545860 |
---|---|
Entity Type | Organization |
Authorized Contact | ERIC BOON Officer/Authorized Official 480-567-0269 |
Organization Subpart ? | No |
Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
Enumeration Date | 2022-11-22 |
Last Update Date | 2024-01-10 |