| NPI | 1801238498 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANE WILLIAMS Owner 520-204-1629 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 363AS0400X Physician Assistant Surgical |
| Additional Taxonomies | 281P00000X Chronic Disease Hospital |
| Enumeration Date | 2013-07-23 |
| Last Update Date | 2022-07-21 |