| NPI | 1902009897 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT BRUCE BANNISTER Medical Director 775-887-3392 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2400X Clinic/Center, Prison Health |
| Enumeration Date | 2007-06-07 |
| Last Update Date | 2020-08-22 |