| NPI | 1982072096 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEO JEROME ANKENBRANDT Sole Proprioter 602-866-1543 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: AZ 3720) |
| Enumeration Date | 2015-09-04 |
| Last Update Date | 2015-09-04 |