| NPI | 1780984823 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHENS TRIPLETT Owner 928-425-8489 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR1300X Clinic/Center, Rural Health (Licence: AZ OTC - Pending) |
| Enumeration Date | 2010-10-22 |
| Last Update Date | 2010-10-22 |