| NPI | 1407584741 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MEKESHA COPELAND Owner/Manager 602-578-9497 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 163W00000X Registered Nurse |
| 164W00000X Licensed Practical Nurse | |
| 164X00000X Licensed Vocational Nurse | |
| 207Q00000X Family Medicine | |
| 207V00000X Obstetrics & Gynecology | |
| 207R00000X Internal Medicine | |
| 208000000X Pediatrics | |
| 208100000X Physical Medicine & Rehabilitation | |
| 225100000X Physical Therapist | |
| 227800000X Respiratory Therapist, Certified | |
| 363A00000X Physician Assistant | |
| 363L00000X Nurse Practitioner | |
| 364S00000X Clinical Nurse Specialist | |
| 376K00000X Nurse's Aide | |
| Enumeration Date | 2022-08-14 |
| Last Update Date | 2022-08-14 |