| NPI | 1902858533 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOUGLAS WAYNE ROTHROCK Owner/Provider 928-776-0601 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: AZ 26235) |
| Additional Taxonomies | 207RS0012X Internal Medicine Sleep Medicine |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2016-11-17 |