NPI | 1942607296 |
---|---|
Entity Type | Organization |
Authorized Contact | GERARD QUIGLEY Provider/Owner 480-347-6474 |
Organization Subpart ? | No |
Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: AZ AP4985) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AZ AP4985) |
Enumeration Date | 2014-12-02 |
Last Update Date | 2015-04-05 |