| NPI | 1265786388 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRENDA ANN WELLS Physician/Owner 520-818-8477 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2012-10-29 |
| Last Update Date | 2017-08-24 |