| NPI | 1891820742 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BECKY SUE SWALLOW Office Mgr. 775-753-6886 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: NV 11565) |
| Enumeration Date | 2007-02-22 |
| Last Update Date | 2020-08-22 |