| NPI | 1578797122 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WYATT D WOODARD CEO 928-779-0361 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: AZ AP1235) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: AZ AP1235) |
| Enumeration Date | 2009-05-12 |
| Last Update Date | 2009-06-01 |