| NPI | 1265835599 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORRAINE HANNA MANCIET President 520-744-7496 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: AZ 43719) |
| Enumeration Date | 2014-10-01 |
| Last Update Date | 2014-10-01 |