NPI | 1801464110 |
---|---|
Entity Type | Organization |
Authorized Contact | GENNIE M BUDET Billing/Credentialing 702-462-9729 |
Organization Subpart ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
Additional Taxonomies | 111N00000X Chiropractor |
171100000X Acupuncturist | |
171400000X Health & Wellness Coach | |
175F00000X Naturopath | |
207K00000X Allergy & Immunology | |
207Q00000X Family Medicine | |
225100000X Physical Therapist | |
261Q00000X Clinic/Center | |
261QM1300X Clinic/Center, Multi-Specialty | |
261QM2500X Clinic/Center, Medical Specialty | |
332B00000X Durable Medical Equipment & Medical Supplies | |
Enumeration Date | 2021-06-14 |
Last Update Date | 2024-07-09 |