| NPI | 1790822864 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYDIA LANSBERRY Practice Administrator 520-293-6740 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: AZ z3c0001059) |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2024-12-26 |