| NPI | 1356824759 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY M PETERS CEO 480-895-0276 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist Foot & Ankle Surgery |
| Additional Taxonomies | 213EP1101X Podiatrist Primary Podiatric Medicine |
| Enumeration Date | 2018-09-11 |
| Last Update Date | 2018-09-11 |