| NPI | 1609050749 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARLTON A RICHIE Owner/Physician 480-751-3771 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QS0010X Family Medicine Sports Medicine (Licence: AZ 3440) |
| Enumeration Date | 2007-12-26 |
| Last Update Date | 2008-02-01 |