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NPI Code Detail

MEDICARE: ADVANCED SPINE & REHABILITATION LLC

MEDICARE: ADVANCED SPINE & REHABILITATION 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
1111N00000XChiropractor

General Provider Information

NPI Number : 1295774263
Entity Type Code : Organization
Provider Name (Legal Business Name) : ADVANCED SPINE & REHABILITATION LLC
Provider Business Mailing Address
First Line : 715 MALL RING CIRCLE
Second Line : #205
City : HENDERSON
State : NV
Zip : 89014-6667
Country : US
Telephone Number : 702-339-1142
Fax Number : 702-897-2896
Provider Business Practice Location Address
First Line : 715 MALL RING CIRCLE
Second Line : #205
City : HENDERSON
State : NV
Zip : 89014-6667
Country : US
Telephone Number : 702-339-1142
Fax Number : 702-897-2896
Authorized Official
Title or Position : PARTNER
Name : ALEXANDER S JANDA
Credential : DO
Telephone Number : 702-990-2225
Provider Enumeration Date : 06/05/2006
Last Update Date : 08/22/2020

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Directions to “ADVANCED SPINE & REHABILITATION LLC ” Practice Location

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