NPI | 1538778634 |
---|---|
Entity Type | Organization |
Authorized Contact | LETANIYA WARREN TATUM Owner 702-680-0600 |
Organization Subpart ? | No |
Primary Taxonomy | 261Q00000X Clinic/Center |
Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
261QU0200X Clinic/Center, Urgent Care | |
Enumeration Date | 2020-07-24 |
Last Update Date | 2022-04-06 |