| NPI | 1891204533 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUSTIN LECOMPTE Manager 480-213-8488 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: AZ OSC-17-1451) |
| Enumeration Date | 2017-09-26 |
| Last Update Date | 2022-07-21 |