| NPI | 1750823159 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN LUKE Managing Member 480-269-4397 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 207ND0900X Dermatology, Dermatopathology | |
| 207Q00000X Family Medicine | |
| 111N00000X Chiropractor | |
| 207N00000X Dermatology | |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| Enumeration Date | 2016-11-16 |
| Last Update Date | 2016-11-16 |