| NPI | 1245525914 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACKIE M KYPTA President 928-714-9379 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AZ AP8050) |
| Enumeration Date | 2011-06-10 |
| Last Update Date | 2015-11-05 |