| NPI | 1336384551 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER G REYNOSO Practice Administrator 480-659-1509 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AZ 12818) |
| Enumeration Date | 2008-12-03 |
| Last Update Date | 2010-03-05 |