| NPI | 1932349867 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOL MARIE MOODY Office Manager 928-284-0166 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: AZ 5669) |
| Enumeration Date | 2009-03-05 |
| Last Update Date | 2022-07-18 |