Innovative Mt LLC
NPI #1184147712 in Las Vegas, Nevada
Provider Information
- NPI Number
- 1184147712
- Entity Type
- Organization
- Organization Name
- Innovative Mt LLC
- Primary Specialty
- Nurse Practitioner - Family
- Enumeration Date
- Jul 25, 2017
- Last Updated
- Jul 21, 2022
Practice Location
Authorized Official
- Name
- MR. KENNETH TAM
- Title
- PRACTICE MANAGER
- Phone
- (702) 706-2804
Specialties & Taxonomy Codes
| Specialty |
|---|
| Nurse Practitioner - Family — Family |
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