| NPI | 1477587335 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROGER LESLIE MCCOY President 480-222-3384 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QS0010X Family Medicine Sports Medicine (Licence: AZ 22472) |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2007-08-23 |