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General NPI Number Information
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NPI Number | 1346674785
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Entity Type | Organization
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Legal Business Name | CENTENNIAL WELLNESS CENTER
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Dates
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Enumeration Date | 08/21/2013
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Last Update Date | 08/21/2013
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Provider Practice Location Address
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Address Line | 7910 W TROPICAL PKWY STE. 110
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City | LAS VEGAS
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State | NV
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Zip | 89149-4554
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Country | US
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Telephone | 702-458-2225
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Fax | 702-396-4536
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Provider Business Mailing Address
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Address Line | 7910 W TROPICAL PKWY STE. 110
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City | LAS VEGAS
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State | NV
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Zip | 89149-4554
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Country | US
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Telephone | 702-458-2225
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Fax | 702-396-4536
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Authorized Official
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Title or Position | OWNER/ CHIROPRACTOR
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Name | DR. DANIELLE BUDA
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Credential | D.C.
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Telephone | 702-458-2225
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | B00803
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License Number State | NV
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