| NPI | 1679628531 |
|---|---|
| Doing Business As | SALT RIVER PROFESSIONAL SERVICES |
| Entity Type | Organization |
| Authorized Contact | LAURA A TILLMAN Cmo 602-263-1674 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism | |
| 207RN0300X Internal Medicine, Nephrology | |
| 208000000X Pediatrics | |
| 363LF0000X Nurse Practitioner, Family | |
| 367A00000X Advanced Practice Midwife | |
| Enumeration Date | 2007-01-23 |
| Last Update Date | 2021-05-26 |