| NPI | 1619579422 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARRIE A HORNER Treasurer And Secretary 520-979-0301 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207QA0401X Family Medicine, Addiction Medicine |
| Enumeration Date | 2020-11-16 |
| Last Update Date | 2023-03-07 |