NPI | 1831895861 |
---|---|
Entity Type | Organization |
Authorized Contact | LEEANN JENNINGS Clinic Owner 480-231-9569 |
Organization Subpart ? | No |
Primary Taxonomy | 208D00000X General Practice |
Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty |
363L00000X Nurse Practitioner | |
Enumeration Date | 2023-02-01 |
Last Update Date | 2023-05-24 |