| NPI | 1801142344 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JADE MADISON Owner 702-499-0994 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist |
| Additional Taxonomies | 225XP0019X Occupational Therapist, Physical Rehabilitation |
| Enumeration Date | 2012-08-02 |
| Last Update Date | 2012-08-02 |