| NPI | 1871115592 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELLIE DESCALZO Credentialing Officer 480-926-7800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 225100000X Physical Therapist |
| 363A00000X Physician Assistant | |
| 111N00000X Chiropractor | |
| 207R00000X Internal Medicine | |
| 363LF0000X Nurse Practitioner, Family | |
| Enumeration Date | 2020-05-15 |
| Last Update Date | 2021-05-04 |