| NPI | 1841316841 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIC BOON Authorized Official 480-567-0269 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: HI OHCA FSOF 15) |
| Enumeration Date | 2007-03-21 |
| Last Update Date | 2025-01-12 |