Organization
SOUTH VALLEY PEDIATRIC CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. GALE LYNN KOCH (OWNER)
(702) 492-0004
Entity
Organization
Contact information
Practice address
2610 W HORIZON RIDGE PKWY, SUITE 200, HENDERSON, NV 89052-2869
(702) 492-0004
(702) 492-0006
Mailing address
2610 W HORIZON RIDGE PKWY, SUITE 200, HENDERSON, NV 89052-2869
(702) 492-0004
(702) 492-0006
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
APN000878
NV
Other
Enumeration date
05/29/2007
Last updated
08/22/2020
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