| NPI | 1881261857 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BECKY JOHNSON Practice Administraitor 928-251-4244 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine |
| Enumeration Date | 2021-06-08 |
| Last Update Date | 2025-06-25 |