| NPI | 1609346303 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AZUL COHLMIA Chief Operating Officer 208-600-1550 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0129X |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2018-11-26 |
| Last Update Date | 2024-05-14 |