| NPI | 1801200191 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER LYNCH MARSH Statutory Agent 520-797-5603 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: AZ AZ2532) |
| Enumeration Date | 2014-06-16 |
| Last Update Date | 2015-08-31 |