| NPI | 1245423219 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWARD JAMES BODMER President 480-363-3066 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: AZ 0152) |
| Enumeration Date | 2007-08-23 |
| Last Update Date | 2007-08-23 |