NPI | 1780689802 |
---|---|
Entity Type | Organization |
Authorized Contact | ERIC BOON Officer, Authorized Official 480-567-0269 |
Organization Subpart ? | No |
Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: CA 030000705) |
Enumeration Date | 2005-06-15 |
Last Update Date | 2024-10-15 |