| NPI | 1558896746 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HARRISON HATFIELD President 928-708-9960 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: AZ BL-01985) |
| Enumeration Date | 2017-04-25 |
| Last Update Date | 2017-04-25 |