| NPI | 1790310761 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY A HIRST Owner, Authorized Official 480-246-7353 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0000X |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2020-03-10 |
| Last Update Date | 2020-03-10 |