| NPI | 1770798852 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICTORIA A TRONCOSO Provider 480-391-7631 |
| Organization Subpart ? | No |
| Primary Taxonomy | 204C00000X Neuromusculoskeletal Medicine, Sports Medicine (Licence: AZ DO2849) |
| Enumeration Date | 2007-05-11 |
| Last Update Date | 2008-09-10 |