| NPI | 1356686646 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK LAURSEN Owner 928-282-0774 |
| Organization Subpart ? | No |
| Primary Taxonomy | 175L00000X Homeopath |
| Additional Taxonomies | 132700000X Dietary Manager |
| Enumeration Date | 2012-11-28 |
| Last Update Date | 2012-11-28 |