| NPI | 1427710177 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EUGENE SAMUELS Legal Counsel 480-393-0684 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 261QH0100X Clinic/Center Health Service |
| Enumeration Date | 2021-10-11 |
| Last Update Date | 2022-07-13 |