| NPI | 1821293580 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KARLA SUE VITALE Owner 623-537-5170 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: AZ 3874) |
| Enumeration Date | 2007-06-20 |
| Last Update Date | 2008-08-18 |