| NPI | 1821854712 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIRSTEN A SORENSEN Administrator 602-431-1152 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0401X Family Medicine, Addiction Medicine |
| Enumeration Date | 2024-02-27 |
| Last Update Date | 2024-02-27 |