| NPI | 1245396811 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTI SUE BOURNE Owner 602-971-5002 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: AZ 19443) |
| Enumeration Date | 2006-12-28 |
| Last Update Date | 2020-08-22 |