| NPI | 1265848105 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK MITCHELL Owner/Manager 480-256-1518 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: AZ 3740) |
| Enumeration Date | 2014-07-10 |
| Last Update Date | 2014-12-19 |