| NPI | 1639644909 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TONIA LANETTE GRAHAM Co Owner 623-322-0099 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 261QU0200X Clinic/Center, Urgent Care | |
| Enumeration Date | 2018-10-12 |
| Last Update Date | 2020-03-06 |