NPI | 1104700301 |
---|---|
Entity Type | Organization |
Authorized Contact | GARY BROOKS Owner 775-544-8873 |
Organization Subpart ? | No |
Primary Taxonomy | 261Q00000X Clinic/Center |
Additional Taxonomies | 261QI0500X Clinic/Center, Infusion Therapy |
363L00000X Nurse Practitioner | |
Enumeration Date | 2025-08-01 |
Last Update Date | 2025-09-18 |