| NPI | 1639643307 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MONICA RIOS Credentialing Manager 702-310-9110 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation Pain Medicine |
| Additional Taxonomies | 261QU0200X Clinic/Center Urgent Care |
| Enumeration Date | 2019-01-16 |
| Last Update Date | 2019-01-16 |