Organization
GOLD CANYON FAMILY PRACTICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAITON RUTKOWSKI (CEO)
(480) 982-3691
Entity
Organization
Contact information
Practice address
6820 S KINGS RANCH RD STE 130, GOLD CANYON, AZ 85118-2959
(480) 347-1321
(480) 982-3692
Mailing address
6820 S KINGS RANCH RD STE 130, GOLD CANYON, AZ 85118-2959
(480) 347-1321
(480) 982-3692
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
AZ
Other
Enumeration date
03/16/2011
Last updated
09/20/2011
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