| NPI | 1831500883 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN PAUL MOODY President 1702-458-1495 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: NV B00793) |
| Enumeration Date | 2014-05-13 |
| Last Update Date | 2014-05-13 |