| NPI | 1275767410 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FIBIA O COMAN Owner/Manager 623-434-5567 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: AZ ALH6406) |
| Enumeration Date | 2009-05-02 |
| Last Update Date | 2009-05-02 |