| NPI | 1932091097 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICHOLAS AARON TJALAS Chief Financial Officer 520-784-3809 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2025-07-15 |
| Last Update Date | 2025-07-15 |