Healthcare Provider Details

I. General information

NPI: 1629007323
Provider Name (Legal Business Name): WERNER INSTITUTE OF BALANCE & DIZZINESS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/03/2006
Last Update Date: 08/22/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9080 W CHEYENNE AVE STE 150
LAS VEGAS NV
89129-8932
US

IV. Provider business mailing address

9080 W CHEYENNE AVE STE 150
LAS VEGAS NV
89129-8932
US

V. Phone/Fax

Practice location:
  • Phone: 702-880-1515
  • Fax: 702-880-1511
Mailing address:
  • Phone: 702-880-1515
  • Fax: 702-880-1511

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberA-012
License Number StateNV
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number1348
License Number StateNV

VIII. Authorized Official

Name: BRIAN K WERNER
Title or Position: PRESIDENT
Credential: M.P.T.
Phone: 702-880-1515