| NPI | 1316765753 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IVORIE COLEMAN Physician 480-888-5029 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| Enumeration Date | 2024-10-02 |
| Last Update Date | 2024-10-02 |