Healthcare Provider Details

I. General information

NPI: 1285028910
Provider Name (Legal Business Name): JUSTINE N LOMBOY DC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/19/2015
Last Update Date: 12/04/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7975 BADURA AVE STE 1015
LAS VEGAS NV
89113
US

IV. Provider business mailing address

452 E SILVERADO RANCH BLVD # 128
LAS VEGAS NV
89183-6210
US

V. Phone/Fax

Practice location:
  • Phone: 702-966-5920
  • Fax:
Mailing address:
  • Phone: 702-966-5920
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberB01600
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: