| NPI | 1548627664 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JODY BETH GONZALEZ Insurance Specialist 928-775-6284 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services |
| Enumeration Date | 2016-01-20 |
| Last Update Date | 2016-01-20 |