| NPI | 1780881375 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRY ESPIRITU Member 623-434-0336 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care (Licence: AZ 31859AZ) |
| Enumeration Date | 2007-06-28 |
| Last Update Date | 2008-09-30 |