| NPI | 1871723866 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTINA LYNN SPICER Owner 480-510-2818 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: AZ 3580) |
| Enumeration Date | 2009-07-23 |
| Last Update Date | 2009-09-28 |