| NPI | 1497873475 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOUGLAS B HERMANSEN Owner 702-658-8800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 111N00000X Chiropractor |
| Enumeration Date | 2007-03-27 |
| Last Update Date | 2020-08-22 |