| 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 |