| NPI | 1497272298 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTHONY JAMES PIVONKA President 480-892-0022 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 111N00000X Chiropractor |
| 208VP0000X Pain Medicine Pain Medicine | |
| 225100000X Physical Therapist | |
| Enumeration Date | 2017-08-23 |
| Last Update Date | 2017-08-23 |