| NPI | 1447909171 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLEY JEAN DARNELL Administrator 623-363-4157 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2022-03-21 |
| Last Update Date | 2026-07-16 |