| NPI | 1902768070 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELE TUCKER Practice Manager 480-201-5264 |
| Organization Subpart ? | No |
| Primary Taxonomy | 163WR0006X Registered Nurse, Registered Nurse First Assistant |
| Enumeration Date | 2025-11-26 |
| Last Update Date | 2025-11-26 |