| NPI | 1982947701 |
|---|---|
| Doing Business As | MOON WALK CARDIO |
| Entity Type | Organization |
| Authorized Contact | DENNIS LAVERN DUBOIS Managing Member 702-373-8151 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services |
| Additional Taxonomies | 261QP2000X Clinic/Center, Physical Therapy |
| Enumeration Date | 2013-03-29 |
| Last Update Date | 2013-03-29 |