| NPI | 1053322834 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL GARRETT MATHEWSON Payer Contracting 702-562-0458 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2006-08-10 |
| Last Update Date | 2007-10-25 |