| NPI | 1720355621 |
|---|---|
| Doing Business As | STOCKRIDGE MEN'S MEDCENTER |
| Entity Type | Organization |
| Authorized Contact | SAMUEL A MUJICA TRENCHE Sole Member 702-888-0052 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208800000X Urology |
| Enumeration Date | 2011-11-19 |
| Last Update Date | 2012-03-16 |