| NPI | 1760453054 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELE N AXLUND CFO 928-645-5113 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: AZ BH-2466) |
| Enumeration Date | 2006-01-27 |
| Last Update Date | 2012-09-26 |