| NPI | 1801100250 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH GAYLE LAWLOR Ownerphysician 928-717-8838 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RR0500X Internal Medicine Rheumatology (Licence: AZ 5487) |
| Enumeration Date | 2010-07-27 |
| Last Update Date | 2010-07-27 |