| NPI | 1578718961 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY K MCNICHOLS Sole Owner 520-219-2474 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AZ 40509) |
| Enumeration Date | 2008-11-26 |
| Last Update Date | 2008-11-26 |