| NPI | 1942496955 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALICIA KAYLE GUICE Owner 623-933-7900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AZ 28062) |
| Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: AZ 28062) |
| Enumeration Date | 2007-09-24 |
| Last Update Date | 2012-02-21 |