| NPI | 1952642068 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOUGLAS J CAMPBELL Owner 928-445-5339 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center Medical Specialty (Licence: AZ 28543) |
| Enumeration Date | 2013-03-14 |
| Last Update Date | 2013-03-14 |