| NPI | 1962881961 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TREVER JAY PENNY Managing Member 623-463-1000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: AZ 5085) |
| Enumeration Date | 2015-05-22 |
| Last Update Date | 2015-05-22 |