| 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 |