Graduated: 2021
NPI: 1659941433
Practice Locations (2)
DHHS PHS NAIHS CHINLE COMPREHENSIVE HEALTH CARE FACILITY
2175 STATE RD, SUITE 4
PINON, AZ 865102147
9287259000
TEMPLE FACULTY PRACTICE PLAN INC
3401 N BROAD ST
PHILADELPHIA, PA 191405103
2157073008
Source: CMS National Downloadable File, September 2026.