| NPI | 1831545417 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN P CANTWELL Pac, Owner/Manager 602-908-2025 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant Surgical (Licence: AZ 3145) |
| Enumeration Date | 2016-05-12 |
| Last Update Date | 2016-08-24 |