| NPI | 1225408453 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUSSELL PAUL CHICK Authorized Official/Owner 602-277-1558 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery Sports Medicine (Licence: AZ 11334) |
| Enumeration Date | 2015-09-30 |
| Last Update Date | 2015-09-30 |