NPI | 1619633088 |
---|---|
Doing Business As | INNOVATIVE PRIMARY CARE CLINIC OF HAVASU |
Entity Type | Organization |
Authorized Contact | LOIDA LOYOLA ARQUIZA Primary Provider 240-535-0065 |
Organization Subpart ? | No |
Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
Enumeration Date | 2021-11-10 |
Last Update Date | 2021-11-10 |