| NPI | 1386521607 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CORY DAVIDSON CEO 602-821-1390 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 305S00000X Point of Service |
| Enumeration Date | 2025-08-19 |
| Last Update Date | 2025-08-28 |