| NPI | 1740767003 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHASE GARNER Office Manager 702-462-5076 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2018-07-19 |
| Last Update Date | 2021-08-23 |