| NPI | 1457714388 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHLEEN E BAGWELL General Manager 480-545-2610 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical |
| Additional Taxonomies | 246ZC0007X Specialist/Technologist, Other, Surgical Assistant |
| Enumeration Date | 2016-03-29 |
| Last Update Date | 2022-01-11 |