| NPI | 1609450089 |
|---|---|
| Former Legal Business Name | MODO BIO HEALTH SYSTEMS LLC |
| Entity Type | Organization |
| Authorized Contact | GARY VISSER Medical Director 480-681-0406 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Enumeration Date | 2021-05-11 |
| Last Update Date | 2021-05-11 |