NPI | 1982249496 |
---|---|
Entity Type | Organization |
Authorized Contact | ELLIE DESCALZO Credentialing Officer 480-926-7800 |
Organization Subpart ? | No |
Primary Taxonomy | 208D00000X General Practice |
Additional Taxonomies | 225100000X Physical Therapist |
363LF0000X Nurse Practitioner, Family | |
111NR0400X Chiropractor, Rehabilitation | |
207Q00000X Family Medicine | |
Enumeration Date | 2019-11-08 |
Last Update Date | 2021-08-19 |