| NPI | 1831344035 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REBECCA RAZO Director Of Contracts And Licensing 602-258-6797 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: AZ OTC5327) |
| Additional Taxonomies | 251S00000X (Licence: AZ OTC-5327) |
| Enumeration Date | 2008-12-02 |
| Last Update Date | 2024-06-07 |