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SURPRISE, AZ
NPI1801586748
Entity TypeOrganization
Authorized ContactJERMAINE DAVIS
COO
708-275-9244
Organization Subpart ?No
Primary Taxonomy261Q00000X Clinic/Center
Enumeration Date2023-05-12
Last Update Date2023-05-12
Business Address
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15148 W CORTEZ ST
SURPRISE, AZ 85379-5237
Phone number: 708-275-9244
Mailing Address
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15148 W CORTEZ ST
SURPRISE, AZ 85379-5237
Phone number: