MEDICARE: WRM LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	133N00000X	Nutritionist	2001283320	NV

General Provider Information

NPI Number	:	1154726735
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WRM LLC

Provider Business Mailing Address
First Line	:	8826 S EASTERN AVE STE 111
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89123-4826
Country	:	US
Telephone Number	:	702-478-5080
Fax Number	:	702-297-6586

Provider Business Practice Location Address
First Line	:	8826 S EASTERN AVE STE 111
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89123-4826
Country	:	US
Telephone Number	:	702-478-5080
Fax Number	:	702-297-6586

Authorized Official
Title or Position	:	PRESIDENT
Name	:	SHERRY LOUISE HOPKINS
Credential	:	CPM
Telephone Number	:	702-478-5080

Provider Enumeration Date	:	10/25/2014
Last Update Date	:	10/25/2014

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Directions to “WRM LLC ” Practice Location

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