| NPI | 1366764045 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT CARSON PATTON Owner/Executive Director 928-443-8767 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: AZ OTC6727) |
| Additional Taxonomies | 251S00000X (Licence: AZ BH-3525) |
| Enumeration Date | 2010-02-22 |
| Last Update Date | 2016-04-21 |