| NPI | 1831557321 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN WADE MILLHOLLON Doctor/President 480-705-8844 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: AZ 21604) |
| Enumeration Date | 2016-01-29 |
| Last Update Date | 2021-10-29 |