| NPI | 1487881561 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON COREY BULLARD President 928-273-7501 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: CA H-102091) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: CA 102091) |
| 175L00000X Homeopath (Licence: CA 102091) | |
| 251E00000X Home Health (Licence: CA 102091) | |
| Enumeration Date | 2009-06-16 |
| Last Update Date | 2009-06-16 |