| NPI | 1982016697 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANN ROGGENBUCK CEO 928-233-5110 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: MN R 196496-7) |
| Enumeration Date | 2014-05-29 |
| Last Update Date | 2014-05-29 |