| NPI | 1205821097 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAM MOUSSA President 520-721-2728 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: AZ OSC3020) |
| Enumeration Date | 2005-09-16 |
| Last Update Date | 2020-08-22 |