NPI | 1265037485 |
---|---|
Entity Type | Organization |
Authorized Contact | KATRINA SPRADLING Co Owner 623-208-0589 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
363LP2300X Nurse Practitioner, Primary Care | |
Enumeration Date | 2020-12-03 |
Last Update Date | 2020-12-03 |