| NPI | 1962982397 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWARD J HUDSON Chief Financial Officer 520-322-6274 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: AZ OTC9032) |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2018-08-15 |
| Last Update Date | 2023-09-18 |