| NPI | 1457604019 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NANCY ANN PIERCE Provider 928-649-8250 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: AZ AP2192) |
| Enumeration Date | 2012-10-19 |
| Last Update Date | 2019-08-28 |