NPI | 1740790823 |
---|---|
Doing Business As | KETAMINE INFUSION CENTERS |
Entity Type | Organization |
Authorized Contact | SONNY DIAZ Director 602-344-9850 |
Organization Subpart ? | No |
Primary Taxonomy | 261QI0500X Clinic/Center, Infusion Therapy |
Additional Taxonomies | 261Q00000X Clinic/Center |
Enumeration Date | 2017-10-03 |
Last Update Date | 2021-07-30 |