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General NPI Number Information
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NPI Number | 1720957111
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Entity Type | Organization
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Legal Business Name | VALLEY PAIN & WELLNESS LLC
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Dates
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Enumeration Date | 11/03/2025
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Last Update Date | 11/03/2025
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Provider Practice Location Address
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Address Line | 2121 E FLAMINGO RD STE 208
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City | LAS VEGAS
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State | NV
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Zip | 89119-5124
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Country | US
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Telephone | 702-430-1112
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Fax | 702-268-8950
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Provider Business Mailing Address
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Address Line | 2121 E FLAMINGO RD STE 208
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City | LAS VEGAS
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State | NV
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Zip | 89119-5124
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Country | US
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Telephone | 725-326-0451
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Fax | 702-268-8950
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Authorized Official
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Title or Position | MANAGER
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Name | MR. RONALD LEE MOORE
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Credential |
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Telephone | 702-430-1112
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number |
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License Number State |
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