| NPI | 1235303744 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON LEE LOTH Owner/Physician 480-812-9000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111NS0005X Chiropractor Sports Physician (Licence: AZ 5900) |
| Enumeration Date | 2008-04-15 |
| Last Update Date | 2010-05-26 |