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General NPI Number Information
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NPI Number | 1568169985
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Entity Type | Individual
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Provider Name | MARC ANTHONY BARBOSE N.D., R.PH.
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Gender | Male
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Dates
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Enumeration Date | 02/15/2023
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Last Update Date | 02/15/2023
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Provider Practice Location Address
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Address Line | 12 VISTA OUTLOOK ST
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City | HENDERSON
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State | NV
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Zip | 89011-3165
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Country | US
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Telephone | 702-339-3487
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Fax |
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Provider Business Mailing Address
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Address Line | 12 VISTA OUTLOOK ST
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City | HENDERSON
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State | NV
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Zip | 89011-3165
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Country | US
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Telephone | 702-339-3487
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 175F00000X
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Taxonomy Name | Naturopath
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 14251
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License Number State | NV
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