| NPI | 1255566477 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDSEY R CHITWOOD Physician Assistant 520-868-4011 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2400X Clinic/Center, Prison Health (Licence: AZ 3816) |
| Enumeration Date | 2009-05-18 |
| Last Update Date | 2009-05-18 |