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General NPI Number Information
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NPI Number | 1245012731
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Entity Type | Organization
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Legal Business Name | ACCESS HEALTH & JOINT REJUVENATION CLINIC, INC
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Dates
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Enumeration Date | 10/18/2023
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Last Update Date | 11/01/2023
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Provider Practice Location Address
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Address Line | 3737 PECOS MCLEOD STE 101
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City | LAS VEGAS
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State | NV
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Zip | 89121-4263
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Country | US
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Telephone | 702-369-5436
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Fax | 702-650-2404
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Provider Business Mailing Address
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Address Line | 3737 PECOS MCLEOD STE 101
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City | LAS VEGAS
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State | NV
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Zip | 89121-4263
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Country | US
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Telephone | 702-369-5436
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Fax | 702-650-2404
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | ANDREI RAZADIN
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Credential | CHIROPRACTOR
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Telephone | 702-369-5436
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NI0013X
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Taxonomy Name | Independent Medical Examiner Chiropractor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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Taxonomy #3
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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Taxonomy #4
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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