| NPI | 1437120334 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVEN WORTHEN MORTENSON CEO/ Medical Director 928-445-1234 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS0132X Clinic/Center, Ophthalmologic Surgery |
| Additional Taxonomies | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2006-01-30 |
| Last Update Date | 2017-02-09 |