| NPI | 1982015525 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAENENE K MORROW Business Administrator 928-295-7377 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology |
| Enumeration Date | 2014-05-16 |
| Last Update Date | 2022-12-28 |