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General NPI Number Information
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NPI Number | 1669182242
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Entity Type | Organization
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Legal Business Name | MCQ LYMPHCARE
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Dates
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Enumeration Date | 12/05/2022
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Last Update Date | 02/26/2024
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Provider Practice Location Address
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Address Line | 105 N PECOS RD STE 105
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City | HENDERSON
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State | NV
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Zip | 89074-1995
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Country | US
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Telephone | 702-701-0057
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Fax |
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Provider Business Mailing Address
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Address Line | 8465 W SAHARA AVE STE 111777
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City | LAS VEGAS
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State | NV
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Zip | 89117-8960
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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 | MANAGING MEMBER
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Name | CHLOE PEYTON
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Credential |
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Telephone | 702-701-0057
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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