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General NPI Number Information
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NPI Number | 1922180439
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Entity Type | Organization
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Legal Business Name | DL-JT MANAGEMENT SERVICES, LLC
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Dates
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Enumeration Date | 10/20/2006
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Last Update Date | 09/27/2007
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Provider Practice Location Address
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Address Line | 4454 N DECATUR BLVD
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City | LAS VEGAS
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State | NV
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Zip | 89130-5286
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Country | US
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Telephone | 702-507-0996
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Fax | 702-507-0992
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Provider Business Mailing Address
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Address Line | 4454 N DECATUR BLVD
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City | LAS VEGAS
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State | NV
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Zip | 89130-5286
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Country | US
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Telephone | 702-507-0996
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Fax | 702-507-0992
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Authorized Official
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Title or Position | OWNER
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Name | MR. DAVID LANZKOWSKY
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Credential | M.D.
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Telephone | 702-839-1203
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State |
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