Healthcare Provider Details

I. General information

NPI: 1336937762
Provider Name (Legal Business Name): ELITE 7 SPORTS MEDICINE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/26/2025
Last Update Date: 04/26/2025
Certification Date: 04/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7221 HAZEL PLAIN AVE
LAS VEGAS NV
89131-3227
US

IV. Provider business mailing address

7221 HAZEL PLAIN AVE
LAS VEGAS NV
89131-3227
US

V. Phone/Fax

Practice location:
  • Phone: 888-217-6505
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number State

VIII. Authorized Official

Name: JENNIFER BARRETT
Title or Position: CHIEF OPERATING OFFICER
Credential: ATC, LAT
Phone: 210-860-7532