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69 S Valle Verde Road Henderson NV 89012 | |
(877) 456-5506 | |
Not Available |
Full Name | |
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Speciality | Family Medicine |
Location | 69 S Valle Verde Road, Henderson, Nevada |
Authorized Official Name and Position | Ronald Shumacher (OFFICER) |
Authorized Official Contact | 9522051189 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 692 Minneapolis MN 55440-0692 Ph: () - | 69 S Valle Verde Road Henderson NV 89012 Ph: (877) 456-5506 |
NPI Number | 1629484209 |
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Provider Enumeration Date | 07/03/2014 |
Last Update Date | 05/03/2016 |
Identifier | Type | State | Issuer |
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1629484209 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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