| NPI | 1639710726 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSIE DZIDUCH Owner 480-286-0538 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2019-10-01 |
| Last Update Date | 2023-04-24 |