| NPI | 1295968584 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ADELBERT D EVANGELISTA President 928-782-8056 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AZ 42221) |
| Enumeration Date | 2009-09-02 |
| Last Update Date | 2009-09-17 |