| NPI | 1861839003 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARCEY ILENER ROSIN Owner/Sole Proprietor 520-904-1460 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: AZ 0281) |
| Enumeration Date | 2013-05-29 |
| Last Update Date | 2013-05-29 |