| NPI | 1265958755 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE DIANE TEN EYCK Owner 480-729-4939 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AZ AP7670) |
| Enumeration Date | 2017-08-16 |
| Last Update Date | 2017-08-30 |