| NPI | 1457659708 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JODI LESTER Billing Manager 480-706-0174 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2083P0011X Preventive Medicine, Undersea and Hyperbaric Medicine (Licence: AZ 3344) |
| Enumeration Date | 2011-03-10 |
| Last Update Date | 2011-03-10 |