| NPI | 1265840037 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHELLY DAMSCHRODER Manager/Owner/Provider 928-237-9014 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR1300X Clinic/Center, Rural Health (Licence: AZ AP7289) |
| Enumeration Date | 2014-07-24 |
| Last Update Date | 2015-01-04 |