| NPI | 1881077451 |
|---|---|
| Former Legal Business Name | DESERT SHORES LLC |
| Entity Type | Organization |
| Authorized Contact | TED A COHEN President 702-339-8777 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: NV DPM9301) |
| Enumeration Date | 2015-07-01 |
| Last Update Date | 2015-07-01 |