| NPI | 1922006204 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTHONY M DOMINIC President 480-982-1265 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AZ 1833) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 34002451) |
| Enumeration Date | 2005-07-12 |
| Last Update Date | 2008-01-14 |