| NPI | 1518680347 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMMY LYNN MUSGROVE Administrator 702-561-7851 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2022-09-26 |
| Last Update Date | 2024-03-08 |