| NPI | 1881143147 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HAMBLEN DEAN FULLER Authorized Official 602-793-0310 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center Multi-Specialty |
| Enumeration Date | 2016-09-28 |
| Last Update Date | 2018-08-22 |