| NPI | 1861689986 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SKY MOORE Owner 602-332-2338 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: AZ OTC4249) |
| Enumeration Date | 2007-10-02 |
| Last Update Date | 2007-10-02 |