Healthcare Provider Details

I. General information

NPI: 1376101865
Provider Name (Legal Business Name): INJURY MEDICAL ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/30/2019
Last Update Date: 11/16/2023
Certification Date: 11/16/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2832 E LAKE MEAD BLVD
N LAS VEGAS NV
89030-0157
US

IV. Provider business mailing address

8465 W SAHARA AVE STE 111-249
LAS VEGAS NV
89117-8960
US

V. Phone/Fax

Practice location:
  • Phone: 702-509-5098
  • Fax: 702-924-6356
Mailing address:
  • Phone: 702-509-5098
  • Fax: 702-924-6356

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: MR. JAMES DAVID SALEM II
Title or Position: MANAGING MEMBER
Credential: DC
Phone: 702-509-5098