| NPI | 1851094239 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BROOKE JENSEN Nurse Practitioner 520-409-0845 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 261QH0100X Clinic/Center Health Service |
| 261QI0500X Clinic/Center Infusion Therapy | |
| Enumeration Date | 2023-03-23 |
| Last Update Date | 2023-03-23 |