| NPI | 1902150949 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRI L. REBLIN Office/Billing Manager 602-751-4092 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AZ AP4600) |
| Enumeration Date | 2012-10-30 |
| Last Update Date | 2012-12-08 |