Healthcare Provider Details

I. General information

NPI: 1356724652
Provider Name (Legal Business Name): TANDEM THERAPY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/06/2015
Last Update Date: 07/06/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7261 W CHARLESTON BLVD #101
LAS VEGAS NV
89117-1636
US

IV. Provider business mailing address

7261 W CHARLESTON BLVD #101
LAS VEGAS NV
89117-1636
US

V. Phone/Fax

Practice location:
  • Phone: 702-396-0101
  • Fax:
Mailing address:
  • Phone: 702-396-0101
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number0496
License Number StateNV
# 2
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSP620
License Number StateNV

VIII. Authorized Official

Name: DR. CHRISTOPHER HOLCOMB
Title or Position: SPEECH-LANGUAGE PATHOLOGIST
Credential: PHD., CCC-SLP
Phone: 702-396-0101