| NPI | 1740489251 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH L PETTIT Owner Physician 480-706-0174 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2083P0011X Preventive Medicine, Undersea and Hyperbaric Medicine |
| Enumeration Date | 2007-07-13 |
| Last Update Date | 2018-06-21 |