| NPI | 1881048650 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMBER N HENRY Practice Administrator 602-396-7363 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: AZ 1120808) |
| Enumeration Date | 2016-04-19 |
| Last Update Date | 2025-02-20 |