NPI | 1811515034 |
---|---|
Entity Type | Organization |
Authorized Contact | ERIC BOON Officer/Authorized Official 480-567-0269 |
Organization Subpart ? | No |
Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
Enumeration Date | 2020-07-14 |
Last Update Date | 2024-10-11 |