NPI | 1275526402 |
---|---|
Doing Business As | PRESCOTT MILE HIGH PRIMARY CARE |
Entity Type | Organization |
Authorized Contact | DIETER W. KRANTZ Vice President 928-772-2591 |
Organization Subpart ? | No |
Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
Enumeration Date | 2005-08-23 |
Last Update Date | 2007-08-30 |