| NPI | 1710169180 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSE SAGE HAGGARD Clinic Director 602-463-7177 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: AZ 04836) |
| Enumeration Date | 2007-11-28 |
| Last Update Date | 2007-11-28 |