| NPI | 1346750676 |
|---|---|
| Doing Business As | HAVOC CITY BOXING AND FITNESS |
| Entity Type | Organization |
| Authorized Contact | BRANDON D HARRIS Opm 702-588-3409 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization |
| Enumeration Date | 2017-09-29 |
| Last Update Date | 2017-09-29 |