| NPI | 1780883108 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REAJ VIRGINIA ROBERTS Office Manager 602-214-6154 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: AZ 33846) |
| Enumeration Date | 2007-07-16 |
| Last Update Date | 2007-07-16 |