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General NPI Number Information
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NPI Number | 1710177415
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Entity Type | Organization
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Legal Business Name | JAMES W. SWEDBERG, LLC
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Dates
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Enumeration Date | 07/28/2007
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Last Update Date | 08/27/2020
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Provider Practice Location Address
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Address Line | 1807 W CRAIG RD
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City | N LAS VEGAS
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State | NV
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Zip | 89032-0217
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Country | US
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Telephone | 702-399-1141
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Fax | 702-222-3956
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Provider Business Mailing Address
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Address Line | 9044 WOLF DANCER AVE
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City | LAS VEGAS
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State | NV
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Zip | 89143-5411
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Country | US
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Telephone | 702-353-8534
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Fax | 702-222-3956
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Authorized Official
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Title or Position | MEMBER/MANAGER LLC
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Name | DR. JAMES W. SWEDBERG
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Credential | O.D.
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Telephone | 702-353-8534
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 458
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License Number State | NV
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