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General NPI Number Information
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NPI Number | 1245921295
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Entity Type | Organization
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Legal Business Name | ACCIDENT MEDICAL & INJURY CARE LLC
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Dates
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Enumeration Date | 05/18/2023
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Last Update Date | 05/18/2023
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Provider Practice Location Address
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Address Line | 3830 E FLAMINGO RD STE 201
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City | LAS VEGAS
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State | NV
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Zip | 89121-6234
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Country | US
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Telephone | 702-659-5604
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Fax | 702-660-6186
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Provider Business Mailing Address
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Address Line | 9975 S EASTERN AVE STE 110
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City | LAS VEGAS
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State | NV
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Zip | 89183-7950
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Country | US
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Telephone | 702-600-7977
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CRAIG JORGENSON
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Credential |
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Telephone | 702-279-6977
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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