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General NPI Number Information
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NPI Number | 1093047920
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Entity Type | Organization
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Legal Business Name | WARNER SUPPORT CENTER CORP
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Dates
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Enumeration Date | 02/03/2010
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Last Update Date | 02/03/2010
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Provider Practice Location Address
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Address Line | 8875 W FLAMINGO RD
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City | LAS VEGAS
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State | NV
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Zip | 89147-8730
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Country | US
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Telephone | 702-325-6421
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Fax |
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Provider Business Mailing Address
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Address Line | 8875 W FLAMINGO RD
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City | LAS VEGAS
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State | NV
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Zip | 89147-8730
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | BRUCE S CRAWFORD
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Credential |
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Telephone | 702-325-6421
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number | 9891
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License Number State | NV
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