| NPI | 1578749917 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRET BLACKHART Owner 775-324-0699 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center Ambulatory Surgical (Licence: NV PENDING) |
| Enumeration Date | 2008-01-16 |
| Last Update Date | 2008-01-16 |