NPI | 1588465736 |
---|---|
Entity Type | Organization |
Authorized Contact | DORINE HAYNES Owner 702-412-9077 |
Organization Subpart ? | No |
Primary Taxonomy | 208D00000X General Practice |
Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty |
261QP3300X Clinic/Center, Pain | |
261QU0200X Clinic/Center, Urgent Care | |
Enumeration Date | 2025-03-24 |
Last Update Date | 2025-03-24 |