| NPI | 1386116101 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOANNA SHIELDS Member 602-818-0227 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine |
| Enumeration Date | 2018-12-18 |
| Last Update Date | 2018-12-18 |