| NPI | 1508462441 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMMIE JOBE Office Manager 480-660-8817 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207PS0010X Emergency Medicine, Sports Medicine |
| Additional Taxonomies | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine |
| Enumeration Date | 2020-12-07 |
| Last Update Date | 2021-06-23 |