| NPI | 1881941169 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERESA J TIBBETTS Owner 928-680-4233 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| Enumeration Date | 2012-08-06 |
| Last Update Date | 2012-08-06 |