Organization
BAMBOO FAMILY CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHIRLEY HOLDEMAN (OWNER)
(702) 433-3038
Entity
Organization
Contact information
Practice address
98 E LAKE MEAD PKWY STE 307, HENDERSON, NV 89015-6444
(702) 433-3038
(702) 949-1975
Mailing address
PO BOX 13603, LAS VEGAS, NV 89112-1603
(702) 433-3038
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
261Q00000X
Clinic/Center
—
—
261QP2300X
Primary Care Clinic/Center
—
—
Other
Enumeration date
03/03/2018
Last updated
03/03/2018
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