| NPI | 1417479189 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID GOLAN Owner 480-213-8448 |
| Organization Subpart ? | No |
| Primary Taxonomy | 204C00000X Neuromusculoskeletal Medicine, Sports Medicine (Licence: NV 7091) |
| Enumeration Date | 2017-07-13 |
| Last Update Date | 2022-07-21 |