| NPI | 1790384014 | 
|---|---|
| Doing Business As | MESQUITE VALLEY INTEGRATED HEALTH | 
| Entity Type | Organization | 
| Authorized Contact | TROY FULTON Owner 480-509-7738  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 363LC1500X Nurse Practitioner, Community Health | 
| Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health | 
| Enumeration Date | 2020-10-19 | 
| Last Update Date | 2024-07-23 |