| NPI | 1750523916 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY GRACE WARNER Physician/Owner 602-326-7471 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: AZ 13927) |
| Additional Taxonomies | 261QM2500X Clinic/Center, Medical Specialty (Licence: NM 20040743) |
| 261QM2500X Clinic/Center, Medical Specialty (Licence: MI 4301028720) | |
| Enumeration Date | 2009-04-01 |
| Last Update Date | 2009-04-01 |