Healthcare Provider Details

I. General information

NPI: 1396257390
Provider Name (Legal Business Name): THERAPROS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/30/2017
Last Update Date: 10/30/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4850 W FLAMINGO RD STE 25
LAS VEGAS NV
89103-3707
US

IV. Provider business mailing address

4850 W FLAMINGO RD STE 25
LAS VEGAS NV
89103-3707
US

V. Phone/Fax

Practice location:
  • Phone: 702-871-9917
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0401X
TaxonomyComprehensive Outpatient Rehabilitation Facility (CORF)
License Number
License Number State

VIII. Authorized Official

Name: JOSE ROMMEL VIRAY
Title or Position: OWNER
Credential:
Phone: 702-871-9917