NPI | 1437422425 |
---|---|
Entity Type | Organization |
Authorized Contact | AARON DEGROOT Owner 623-935-7788 |
Organization Subpart ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: AZ 4105) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: AZ 5917) |
261QU0200X Clinic/Center, Urgent Care (Licence: AZ 4105) | |
Enumeration Date | 2012-02-22 |
Last Update Date | 2012-02-22 |