| NPI | 1225158470 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENISE L FAATZ Office Manager 928-704-9202 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| 363AM0700X Physician Assistant Medical | |
| Enumeration Date | 2007-03-30 |
| Last Update Date | 2024-06-18 |