| NPI | 1780001610 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICKI BELT Owner 602-354-5659 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: AZ OSC5336) |
| Enumeration Date | 2014-03-28 |
| Last Update Date | 2014-03-28 |