| NPI | 1720303324 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GERMAN G LASALA Manager 520-991-7258 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care (Licence: AZ 19934) |
| Enumeration Date | 2010-04-07 |
| Last Update Date | 2011-05-16 |