| NPI | 1235100314 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELLISON F HERRO Owner/Medical Director 602-264-1395 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: AZ OSC 0051) |
| Enumeration Date | 2006-01-27 |
| Last Update Date | 2008-03-20 |