| NPI | 1710197272 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAY C LARSON Owner/President 602-938-3600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist Foot & Ankle Surgery (Licence: AZ 0196) |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2021-06-28 |