| NPI | 1568469906 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALICIA ANN SHILLITO Office Manager 928-669-2225 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR1300X Clinic/Center, Rural Health |
| Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: AZ 32755) |
| Enumeration Date | 2005-06-30 |
| Last Update Date | 2016-07-25 |