| NPI | 1386033199 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GRETA IVERS Owner 602-620-5336 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: AZ 47170) |
| Enumeration Date | 2015-01-16 |
| Last Update Date | 2015-02-24 |