| NPI | 1760014658 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GANESH ACHARYA Owner 602-370-0721 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2020-02-07 |
| Last Update Date | 2020-03-19 |