NPI | 1689885543 |
---|---|
Entity Type | Organization |
Authorized Contact | ETTA KOSKOVICH Administrator 623-878-5115 |
Organization Subpart ? | No |
Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: AZ ALC-4673) |
Enumeration Date | 2007-05-24 |
Last Update Date | 2020-08-22 |