MEDICARE: HAZEL GOIS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	175F00000X	Naturopath	2094	OR

General Provider Information

NPI Number	:	1003271271
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HAZEL GOIS LLC

Provider Business Mailing Address
First Line	:	2851 N TENAYA WAY
Second Line	:	SUITE 103
City	:	LAS VEGAS
State	:	NV
Zip	:	89128-0435
Country	:	US
Telephone Number	:	702-656-6608
Fax Number	:	702-658-7117

Provider Business Practice Location Address
First Line	:	2851 N TENAYA WAY
Second Line	:	SUITE 103
City	:	LAS VEGAS
State	:	NV
Zip	:	89128-0435
Country	:	US
Telephone Number	:	702-656-6608
Fax Number	:	702-658-7117

Authorized Official
Title or Position	:	NATUROPATHIC PHYSICIAN
Name	:	DR. HAZEL M GOIS
Credential	:	N.D.
Telephone Number	:	702-656-6608

Provider Enumeration Date	:	12/15/2015
Last Update Date	:	12/15/2015

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Directions to “HAZEL GOIS LLC ” Practice Location

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