MEDICARE: BIOFEEDBACK SPECIALISTS 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	251S00000X	Community/Behavioral Health Agency		NV

General Provider Information

NPI Number	:	1841659307
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BIOFEEDBACK SPECIALISTS LLC

Provider Business Mailing Address
First Line	:	7231 S EASTERN AVE
Second Line	:	STE 220
City	:	LAS VEGAS
State	:	NV
Zip	:	89119-0451
Country	:	US
Telephone Number	:	702-460-9190
Fax Number	:

Provider Business Practice Location Address
First Line	:	7231 S EASTERN AVE
Second Line	:	STE 220
City	:	LAS VEGAS
State	:	NV
Zip	:	89119-0451
Country	:	US
Telephone Number	:	702-460-9190
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	JOSEPH DAKURAS
Credential	:
Telephone Number	:	702-460-9190

Provider Enumeration Date	:	02/12/2016
Last Update Date	:	02/12/2016

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