| NPI | 1750686614 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EMILY CASTILLO Regional Manager 702-480-2550 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: AZ OTC 4998) |
| Enumeration Date | 2011-01-24 |
| Last Update Date | 2024-05-30 |