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General NPI Number Information
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NPI Number | 1659189363
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Entity Type | Organization
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Legal Business Name | CENTER FOR WELLNESS AND PAIN CARE OF LAS VEGAS INC
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Dates
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Enumeration Date | 12/27/2024
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Last Update Date | 12/27/2024
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Provider Practice Location Address
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Address Line | 780 CANTON RD NE STE 330
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City | MARIETTA
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State | GA
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Zip | 30060-7289
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Country | US
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Telephone | 888-387-0080
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Fax |
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Provider Business Mailing Address
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Address Line | 3495 BUCKHEAD LOOP NE # 19018
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City | ATLANTA
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State | GA
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Zip | 30326-1528
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | NEVILLE CAMPBELL
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Credential | MD/MBA
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Telephone | 702-476-9700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP3300X
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Taxonomy Name | Pain Clinic/Center
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License Number |
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License Number State |
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