NPI | 1891914602 |
---|---|
Entity Type | Organization |
Authorized Contact | ROGER WAYNE NUTT President 928-344-4907 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM2500X Clinic/Center Medical Specialty (Licence: AZ 15072) |
Enumeration Date | 2007-04-24 |
Last Update Date | 2009-05-20 |