| NPI | 1720425200 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CANDICE MARIE GAITANIS Owner 480-888-2141 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: AZ AP4770) |
| Enumeration Date | 2013-05-24 |
| Last Update Date | 2013-05-24 |