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NPI Code Detail

MEDICARE: ARICAGA SYNCVITA WELLNESS LLC

MEDICARE: ARICAGA SYNCVITA WELLNESS 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
1261QP2000XPhysical Therapy Clinic/Center

General Provider Information

NPI Number : 1629932207
Entity Type Code : Organization
Provider Name (Legal Business Name) : ARICAGA SYNCVITA WELLNESS LLC
Provider Business Mailing Address
First Line : 645 SOARING WINGS AVE
Second Line :
City : LAS VEGAS
State : NV
Zip : 89183-4311
Country : US
Telephone Number : 702-401-6030
Fax Number : 702-401-6030
Provider Business Practice Location Address
First Line : 645 SOARING WINGS AVE
Second Line :
City : LAS VEGAS
State : NV
Zip : 89183-4311
Country : US
Telephone Number : 702-401-6030
Fax Number : 702-401-6030
Authorized Official
Title or Position : MANAGER
Name : DIANA MKRTCHYAN
Credential :
Telephone Number : 702-401-6030
Provider Enumeration Date : 12/09/2025
Last Update Date : 12/09/2025

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Directions to “ARICAGA SYNCVITA WELLNESS LLC ” Practice Location

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