NPI | 1558523381 |
---|---|
Entity Type | Organization |
Authorized Contact | ANDREI DAMIAN President 602-867-8644 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty |
Additional Taxonomies | 332900000X Non-Pharmacy Dispensing Site |
Enumeration Date | 2008-07-02 |
Last Update Date | 2008-07-02 |