| NPI | 1932845450 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY LEE TOONE Owner 623-203-7103 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 251E00000X Home Health |
| Enumeration Date | 2022-05-08 |
| Last Update Date | 2022-05-08 |