| NPI | 1366796773 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REGINALD M. SUTTON Sole Member 480-686-8737 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine (Licence: AZ 29166) |
| Enumeration Date | 2012-11-07 |
| Last Update Date | 2012-11-07 |