| NPI | 1255955191 |
|---|---|
| Doing Business As | CANYON STATE RHEUMATOLOGY |
| Entity Type | Organization |
| Authorized Contact | KENNETH GAYLE LAWLOR Owner 928-717-8838 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RR0500X Internal Medicine, Rheumatology |
| Enumeration Date | 2020-06-06 |
| Last Update Date | 2020-06-06 |