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General NPI Number Information
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NPI Number | 1699538116
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Entity Type | Organization
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Legal Business Name | RO'MAURE' REGENERATIVE HEALTH & WELLNESS
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Dates
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Enumeration Date | 02/06/2024
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Last Update Date | 02/06/2024
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Provider Practice Location Address
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Address Line | 6578 N DECATUR BLVD STE 138
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City | LAS VEGAS
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State | NV
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Zip | 89131-1036
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Country | US
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Telephone | 702-526-3811
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Fax |
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Provider Business Mailing Address
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Address Line | 7817 LONESOME HARBOR AVE
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City | LAS VEGAS
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State | NV
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Zip | 89131-5002
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Country | US
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Telephone | 702-526-3811
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | TAMMY ROE
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Credential |
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Telephone | 702-860-9179
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number |
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License Number State |
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