| NPI | 1861522419 |
|---|---|
| Doing Business As | BLACK MOUNTAIN FAMILY MEDICINE |
| Entity Type | Organization |
| Authorized Contact | JOHN BICKLE President 480-595-8900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AZ 30905) |
| Enumeration Date | 2007-03-06 |
| Last Update Date | 2008-05-19 |