| NPI | 1861710097 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRIS SHORT Chief Operating Officer 702-489-6305 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: IL 036-114047) |
| Enumeration Date | 2010-05-12 |
| Last Update Date | 2010-05-12 |