| NPI | 1558756783 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WENDY L MILLER Member 520-262-7554 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: AZ 5874) |
| Enumeration Date | 2015-04-04 |
| Last Update Date | 2015-04-20 |