| NPI | 1356548085 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELE FRANCES HUNTER Billing Administrator 928-503-6655 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: AZ RN059345) |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2007-06-27 |
| Last Update Date | 2023-09-20 |