| NPI | 1588832208 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWARD P FULLER President 928-854-5370 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: AZ 26880) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: CA C50618) |
| Enumeration Date | 2008-02-15 |
| Last Update Date | 2008-02-15 |