| NPI | 1619134079 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN J VITAL President 480-924-6169 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: AZ 3270) |
| Enumeration Date | 2008-05-21 |
| Last Update Date | 2008-05-21 |