| NPI | 1700279379 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANICE JOHNSTON Medical Director 623-451-3782 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center Health Service (Licence: AZ AS9056) |
| Enumeration Date | 2015-03-06 |
| Last Update Date | 2018-11-14 |