| NPI | 1649718347 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DWIGHT C BOYD CEO 928-326-0044 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization |
| Additional Taxonomies | 347C00000X Private Vehicle |
| Enumeration Date | 2017-02-02 |
| Last Update Date | 2017-02-02 |