| NPI | 1104424134 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUDI COOPER SMITH Co Owner 702-695-6432 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer |
| Additional Taxonomies | 253Z00000X In Home Supportive Care |
| Enumeration Date | 2020-10-12 |
| Last Update Date | 2020-10-12 |