| NPI | 1467868679 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RENAE GOEDHART Owner 702-682-8155 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center Health Service (Licence: NV APRN000597) |
| Enumeration Date | 2014-07-08 |
| Last Update Date | 2014-07-08 |