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Physicians Neuromusculoskeletal Medicine, Sports Medicine

Provider NPI: 1114901444

Provider Information:
Gender: M
Sole Proprietor

Practice Location:
Tel: 702-982-7100  Fax: 702-982-7102

Business Mailing Address:
PO BOX 531666  HENDERSON, NV 89053-1666 US
Tel: 702-982-7100  Fax: 702-982-7102

NPI Information:
NPI: 1114901444
Entity Type: Individual


PrimaryCodeCategory/DescriptionStateLicense Number
Neuromusculoskeletal Medicine, Sports Medicine
Physical Medicine & Rehabilitation
Durable Medical Equipment & Medical Supplies

Other Provider Identifiers:

GROUP NPI1376795823NV01

American Medical Association 2012 taxonomy code information

Code: 208100000X





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