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General NPI Number Information
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NPI Number | 1881018943
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Entity Type | Organization
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Legal Business Name | R & P ENTERPRISES
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Dates
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Enumeration Date | 02/10/2014
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Last Update Date | 02/10/2014
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Provider Practice Location Address
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Address Line | 7240 W AZURE DR STE 115
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City | LAS VEGAS
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State | NV
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Zip | 89130-4408
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Country | US
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Telephone | 702-979-9050
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Fax |
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Provider Business Mailing Address
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Address Line | 7240 W AZURE DR STE 115
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City | LAS VEGAS
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State | NV
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Zip | 89130-4408
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Country | US
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Telephone | 702-979-9050
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | MS. GAYLA DEANNE COUGHLIN
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Credential | LMT
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Telephone | 702-683-1872
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 172M00000X
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Taxonomy Name | Mechanotherapist
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License Number | M1195059E157289
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License Number State | NV
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