NPI | 1366626400 |
---|---|
Former Legal Business Name | OLIVEVIEW HOMEFRONT |
Entity Type | Organization |
Authorized Contact | TREVOR W WHITMORE Owner/Physician Assistant 480-988-6878 |
Organization Subpart ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: AZ 2399) |
Enumeration Date | 2007-12-26 |
Last Update Date | 2008-06-13 |