MEDICARE: INTEGRATED HEALTH AND WELLNESS CENTER 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	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1790222362
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INTEGRATED HEALTH AND WELLNESS CENTER LLC

Provider Business Mailing Address
First Line	:	11829 LUNA DEL MAR LN
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89138-4529
Country	:	US
Telephone Number	:	702-448-6042
Fax Number	:	702-430-8970

Provider Business Practice Location Address
First Line	:	4215 S GRAND CANYON DR
Second Line	:	SUITE 101
City	:	LAS VEGAS
State	:	NV
Zip	:	89147-7172
Country	:	US
Telephone Number	:	702-448-6042
Fax Number	:	702-430-8970

Authorized Official
Title or Position	:	OWNER/MANAGER
Name	:	MRS. MICHELLE SEAQUIST MAZUROWSKI
Credential	:
Telephone Number	:	702-448-6042

Provider Enumeration Date	:	01/20/2017
Last Update Date	:	05/17/2026

Similar Medicare Providers

1841632866 — FOOD CONNECTION LLC
Practice Location Address:

4215 S GRAND CANYON DR , SUITE 101
LAS VEGAS, NV
89147-7172

Practice Phone: 702-664-1204
Practice Fax:

1528550480 — DANIEL LEVINE
Practice Location Address:

4215 S GRAND CANYON DR
LAS VEGAS, NV
89147-7172

Practice Phone: 702-664-1204
Practice Fax:

1356167258 — PAULINE ANGELICA CORONEL BSN, RN
Practice Location Address:

4634 MISSION MEADOW CIR
LAS VEGAS, NV
89139-7172

Practice Phone: 702-627-4085
Practice Fax:

1740117902 — BRANDY LOVINGIER
Practice Location Address:

1350 E FLAMINGO RD
LAS VEGAS, NV
89119-5263

Practice Phone: 855-832-6727
Practice Fax:

1760404768 — MR. CLARENCE E. GRIM M.D.
Practice Location Address:

1180 N TOWN CENTER DR STE 100
LAS VEGAS, NV
89144-6308

Practice Phone: 414-916-0841
Practice Fax:

1831480532 — E. HARBIN NELSON M.D. PLLC
Practice Location Address:

322 KAREN AVE , #2805
LAS VEGAS, NV
89109-0412

Practice Phone: 800-458-7172
Practice Fax:

Directions to “INTEGRATED HEALTH AND WELLNESS CENTER LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.