Organization
PALM TREE MEDICAL CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACOLBY BLEDSOE (OWNER)
(725) 577-8636
Entity
Organization
Contact information
Practice address
3930 E PATRICK LN, LAS VEGAS, NV 89120-4924
(725) 577-8636
Mailing address
3930 E PATRICK LN, LAS VEGAS, NV 89120-4924
(725) 577-8636
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
—
—
363LP2300X
Primary Care Nurse Practitioner
Primary
—
—
Other
Enumeration date
10/12/2021
Last updated
10/13/2021
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