| NPI | 1902301096 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JODI OSTROM Owner 602-509-9177 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine Adult Medicine (Licence: AZ AP10016) |
| Enumeration Date | 2018-03-29 |
| Last Update Date | 2018-07-25 |