| NPI | 1821515222 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELO JOHN PISANO Member/Manager 602-548-1998 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 111N00000X Chiropractor |
| 208VP0000X Pain Medicine, Pain Medicine | |
| 225100000X Physical Therapist | |
| Enumeration Date | 2017-08-25 |
| Last Update Date | 2017-08-25 |