| NPI | 1366586463 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | INEKE GLAVOR Pa C 775-770-3780  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 261QC1500X Clinic/Center, Community Health (Licence: NV NV 305)  | 
| Enumeration Date | 2007-02-20 | 
| Last Update Date | 2020-08-22 |