| NPI | 1366794919 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICKI L LUGO Practice Manager 480-451-9191 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care (Licence: AZ 21128) |
| Enumeration Date | 2012-10-06 |
| Last Update Date | 2012-10-06 |