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General NPI Number Information
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NPI Number | 1063931269
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Entity Type | Organization
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Legal Business Name | GOLAN INTEGRATED PHYSICAL MEDICINE
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Dates
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Enumeration Date | 09/19/2017
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Last Update Date | 04/25/2022
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Provider Practice Location Address
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Address Line | 2100 E CALVADA BLVD
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City | PAHRUMP
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State | NV
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Zip | 89048-5805
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Country | US
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Telephone | 775-727-7959
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Fax | 775-727-7960
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Provider Business Mailing Address
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Address Line | 2100 E CALVADA BLVD
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City | PAHRUMP
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State | NV
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Zip | 89048-5805
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Country | US
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Telephone | 775-727-7959
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Fax | 775-727-7960
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Authorized Official
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Title or Position | MANAGER
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Name | ANNA CHRISTENSEN
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Credential |
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Telephone | 775-727-7959
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number |
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License Number State | NV
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State |
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