NPI | 1720082621 |
---|---|
Entity Type | Organization |
Authorized Contact | WYATT D WOODARD Owner 928-779-0361 |
Organization Subpart ? | No |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: AZ AP1235) |
Enumeration Date | 2005-06-08 |
Last Update Date | 2011-06-08 |