| NPI | 1205858875 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL LEE HAM Owner/President 928-775-5606 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center Ambulatory Surgical (Licence: AZ OSC 0078) |
| Enumeration Date | 2006-07-24 |
| Last Update Date | 2007-07-10 |