| NPI | 1295148856 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES R STEVENS Owner 928-276-3049 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: AZ 41804) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: CA A104563) |
| Enumeration Date | 2014-06-11 |
| Last Update Date | 2023-05-08 |