| NPI | 1326391301 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORENE MARION Office Manger 775-323-3892 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: NV 5686) |
| Enumeration Date | 2012-10-16 |
| Last Update Date | 2012-10-16 |