| NPI | 1598324733 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JODI LESTER Credentialing Manager 480-219-6631 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 111N00000X Chiropractor |
| Enumeration Date | 2019-06-11 |
| Last Update Date | 2019-06-11 |