| NPI | 1205695962 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACY LEIGH REAL Vice Presdient 928-800-2434 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR1300X Clinic/Center Rural Health |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2024-03-15 |
| Last Update Date | 2024-03-15 |