| NPI | 1730330234 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEFAN DAVID TARLOW President 480-483-0393 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: AZ MD34257) |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2008-10-02 |
| Last Update Date | 2021-03-09 |