| NPI | 1922034495 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDA JENNINGS Owner 602-395-0718 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: AZ rn031133) |
| Enumeration Date | 2006-06-24 |
| Last Update Date | 2010-08-17 |