| NPI | 1639162779 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL ERIC CARRERA Managing Member 480-964-4242 |
| Organization Subpart ? | No |
| Primary Taxonomy | 293D00000X Physiological Laboratory (Licence: AZ OTC5108) |
| Enumeration Date | 2005-08-24 |
| Last Update Date | 2016-03-24 |