| NPI | 1487128476 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARLA E DIANA Manager 602-548-1998 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 208VP0000X Pain Medicine, Pain Medicine |
| 111N00000X Chiropractor | |
| 225100000X Physical Therapist | |
| Enumeration Date | 2019-01-14 |
| Last Update Date | 2019-01-14 |