| NPI | 1942774369 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOUGLAS CLOUSE Member Manager 480-899-4333 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery |
| Additional Taxonomies | 103T00000X Psychologist |
| 111N00000X Chiropractor | |
| 225100000X Physical Therapist | |
| Enumeration Date | 2019-01-18 |
| Last Update Date | 2019-01-18 |