| NPI | 1720839665 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RON OLSEN President/CEO 928-530-3230 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Additional Taxonomies | 213ES0103X Podiatrist Foot & Ankle Surgery |
| Enumeration Date | 2024-03-28 |
| Last Update Date | 2024-08-07 |