| NPI | 1023601085 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL BRADY Owner 775-828-9665 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 208VP0000X |
| Enumeration Date | 2021-02-19 |
| Last Update Date | 2024-02-14 |