| NPI | 1558548487 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HARRY LAVERN GALE President 928-772-1845 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: AZ 2772) |
| Enumeration Date | 2008-01-22 |
| Last Update Date | 2008-02-22 |