| NPI | 1649876103 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUSTIN WILLEY President 520-333-7785 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation |
| Additional Taxonomies | 207R00000X Internal Medicine |
| Enumeration Date | 2020-12-09 |
| Last Update Date | 2020-12-09 |