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General NPI Number Information
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NPI Number | 1447425822
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Entity Type | Organization
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Legal Business Name | PROGRESSIVE HEALTH CENTER OF NEVADA, LLC
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Dates
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Enumeration Date | 04/25/2008
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Last Update Date | 07/31/2008
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Provider Practice Location Address
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Address Line | 5568 S FORT APACHE RD
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City | LAS VEGAS
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State | NV
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Zip | 89148-3602
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Country | US
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Telephone | 517-204-2268
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Fax |
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Provider Business Mailing Address
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Address Line | 5568 S FORT APACHE RD
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City | LAS VEGAS
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State | NV
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Zip | 89148-3602
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Country | US
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Telephone | 517-204-2268
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | DR. MICHAEL J. SOBRAN
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Credential | D.C.
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Telephone | 517-204-2268
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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 |
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License Number State |
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