| NPI | 1285982660 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENDRIC BURTON SPEAGLE CEO 480-612-4889 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0401X Family Medicine Addiction Medicine (Licence: AZ 005284) |
| Enumeration Date | 2012-08-16 |
| Last Update Date | 2012-08-16 |