| NPI | 1376742205 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER LEE SLOCUM WAARA CEO 928-445-5339 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center Medical Specialty (Licence: AZ 36449) |
| Enumeration Date | 2007-07-11 |
| Last Update Date | 2011-12-14 |