Healthcare Provider Details

I. General information

NPI: 1710341938
Provider Name (Legal Business Name): MMM MEDICAL MARKETING & MANAGEMENT, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/13/2016
Last Update Date: 04/13/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4054 DEAN MARTIN DR
LAS VEGAS NV
89103-4195
US

IV. Provider business mailing address

4054 DEAN MARTIN DR
LAS VEGAS NV
89103-4195
US

V. Phone/Fax

Practice location:
  • Phone: 303-667-2301
  • Fax: 888-510-9071
Mailing address:
  • Phone: 303-667-2301
  • Fax: 888-510-9071

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State

VIII. Authorized Official

Name: MISS RONALD GORSCHE
Title or Position: CEO
Credential:
Phone: 303-667-2301