| NPI | 1588854145 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONALD WAYNE RUNYAN Owner 928-726-4234 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207PE0005X Emergency Medicine, Undersea and Hyperbaric Medicine (Licence: AZ 3599) |
| Enumeration Date | 2007-07-30 |
| Last Update Date | 2007-07-31 |