| NPI | 1881340511 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL VASILIAUSKAS Sr. Business Development 602-971-6950 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM1300X Clinic/Center Multi-Specialty |
| Enumeration Date | 2022-02-22 |
| Last Update Date | 2022-02-22 |