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General NPI Number Information
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NPI Number | 1124995410
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Entity Type | Organization
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Legal Business Name | ADVANCED SPINE & REHABILITATION
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Dates
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Enumeration Date | 10/21/2025
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Last Update Date | 10/21/2025
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Provider Practice Location Address
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Address Line | 715 MALL RING CIR STE 100
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City | HENDERSON
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State | NV
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Zip | 89014-6666
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Country | US
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Telephone | 702-990-2225
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Fax | 702-990-7711
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Provider Business Mailing Address
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Address Line | 2168 W GROVE PKWY STE 200
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City | PLEASANT GROVE
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State | UT
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Zip | 84062-6748
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Country | US
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Telephone | 702-990-2225
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Fax | 702-990-7711
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Authorized Official
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Title or Position | PRESIDENT
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Name | NATE D MILLER
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Credential | DC
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Telephone | 702-990-2225
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number |
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License Number State |
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