| NPI | 1922761824 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL VASILIAUSKAS Sr VP Business Developmen 602-971-6950 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2021-10-18 |
| Last Update Date | 2021-10-18 |