| NPI | 1316071822 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYNNELL P GARDNER Owner President 520-298-2313 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: AZ 18444) |
| Enumeration Date | 2007-03-15 |
| Last Update Date | 2020-08-22 |