| NPI | 1770211781 |
|---|---|
| Doing Business As | LAKE HAVASU PEDIATRIC FAMILY CLINIC - MOBILE UNIT |
| Entity Type | Organization |
| Authorized Contact | AMANDA AGUIRRE President & CEO 928-315-7910 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261Q00000X |
| Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2022-08-09 |
| Last Update Date | 2023-09-07 |