Healthcare Provider Details

I. General information

NPI: 1932849577
Provider Name (Legal Business Name): WEKARE MEDICAL CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/31/2022
Last Update Date: 03/31/2022
Certification Date: 03/20/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3930 E PATRICK LN
LAS VEGAS NV
89120-4924
US

IV. Provider business mailing address

9165 DESIRABLE CT
LAS VEGAS NV
89149-3068
US

V. Phone/Fax

Practice location:
  • Phone: 725-577-8636
  • Fax:
Mailing address:
  • Phone: 725-577-8636
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QX0100X
TaxonomyOccupational Medicine Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: PHILLIP BLEDSOE
Title or Position: CEO
Credential:
Phone: 725-577-8636