| NPI | 1316023864 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAWN D ABBOTT Chief Executive Officer 928-757-8111 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: AZ OTC5973) |
| Additional Taxonomies | 261Q00000X Clinic/Center (Licence: AZ BH645) |
| Enumeration Date | 2006-10-27 |
| Last Update Date | 2021-06-23 |