| NPI | 1336687326 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL JEROME DEPENBUSCH President/Owner 480-272-2686 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2017-02-09 |
| Last Update Date | 2024-12-02 |