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General NPI Number Information
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NPI Number | 1942008123
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Entity Type | Organization
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Legal Business Name | HS LV 1 LLC
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Dates
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Enumeration Date | 03/04/2025
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Last Update Date | 03/18/2025
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Provider Practice Location Address
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Address Line | 601 WHITNEY RANCH DR STE C12
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City | HENDERSON
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State | NV
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Zip | 89014-2643
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Country | US
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Telephone | 702-816-5111
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Fax | 702-947-6321
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Provider Business Mailing Address
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Address Line | 8745 STELLA NOVA ST
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City | LAS VEGAS
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State | NV
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Zip | 89139-7240
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Country | US
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Telephone | 702-449-9751
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | THOMAS GODFREY
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Credential | DC
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Telephone | 702-449-9751
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State |
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