| Organization Name: | SAN LUIS WALK IN CLINIC, INC. |
| NPI Number: | 1104228337 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | AMANDA AQUIRRE (PRESIDENT & CEO) |
| Mailing Address: | 1896 E Babbit Lane San Luis |
| State: | AZ US |
| Postal Code: | 85349 |
| Phone Number: | 9287226112 |
| Fax Number: | 8777955018 |
| NPI Enumeration Date: | 09/18/2014 |
| NPI Last Update Date: | 09/18/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2300X |
| License Number: | OCT3530 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AZ |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Primary Care |
| Taxonomy Definition: | |