| NPI | 1689651481 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIC BOON Officer/Authorized Official 480-567-0269 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: WY 0713016) |
| Enumeration Date | 2005-12-22 |
| Last Update Date | 2021-01-08 |