| NPI | 1710420286 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JERI LYNN BROCK President 928-530-4546 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AZ AP7850) |
| Enumeration Date | 2016-11-30 |
| Last Update Date | 2016-11-30 |