Healthcare Provider Details

I. General information

NPI: 1881054930
Provider Name (Legal Business Name): DR. FRANK LIEGGI
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/02/2016
Last Update Date: 03/02/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4107 W CHEYENNE AVE SUITE 205
N LAS VEGAS NV
89032-3476
US

IV. Provider business mailing address

7920 GORGAS CT
LAS VEGAS NV
89129-5566
US

V. Phone/Fax

Practice location:
  • Phone: 702-715-4212
  • Fax:
Mailing address:
  • Phone: 702-715-4212
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: