NPI | 1558365536 |
---|---|
Entity Type | Organization |
Authorized Contact | SHANNON GRAY Administrator Owner 480-398-1228 |
Organization Subpart ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: AZ 29241) |
Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty |
Enumeration Date | 2005-06-08 |
Last Update Date | 2017-12-29 |