| NPI | 1962808303 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUAN CARLOS MARTINEZ-MORENO President 702-826-2816 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation |
| Additional Taxonomies | 332900000X Non-Pharmacy Dispensing Site |
| Enumeration Date | 2014-11-12 |
| Last Update Date | 2015-06-11 |