| NPI | 1619019049 |
|---|---|
| Other Name | NONE |
| Entity Type | Organization |
| Authorized Contact | FRANCES A SKILLERN Administrative Assistant 928-453-9593 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2007-02-13 |
| Last Update Date | 2022-07-28 |