| NPI | 1356754881 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FARAH R LOKEY Medical Director 480-857-6316 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: AZ 40350) |
| Enumeration Date | 2014-06-02 |
| Last Update Date | 2014-06-02 |