| NPI | 1720590672 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRICIA K FORDYCE Business Manager 928-853-4444 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology |
| Additional Taxonomies | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2017-11-01 |
| Last Update Date | 2018-01-17 |