NPI | 1851554240 |
---|---|
Entity Type | Organization |
Authorized Contact | RONALD ANTHONY DICARLO President Owner 928-718-7188 |
Organization Subpart ? | No |
Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: AZ D6061) |
Enumeration Date | 2008-07-07 |
Last Update Date | 2008-07-07 |