| NPI | 1104315647 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TENESHIA DACHELL SPENCER CEO 702-664-1690 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 2251S0007X Physical Therapist, Sports | |
| Enumeration Date | 2018-05-09 |
| Last Update Date | 2018-05-09 |