| NPI | 1831501121 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAWN VIGNEAU Owner 602-889-5833 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 111N00000X Chiropractor |
| 171M00000X Case Manager/Care Coordinator | |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology | |
| Enumeration Date | 2014-05-21 |
| Last Update Date | 2014-05-21 |