| NPI | 1316694912 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LANETTE KEETON Owner 480-562-1974 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2022-03-04 |
| Last Update Date | 2024-01-30 |