| NPI | 1497382501 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK SCHLOTTERBACK Owner 602-525-8663 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207RS0010X Internal Medicine, Sports Medicine |
| Enumeration Date | 2020-03-26 |
| Last Update Date | 2020-03-26 |