MEDICARE: BEST CRANIAL CARE

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	335E00000X	Prosthetic/Orthotic Supplier

General Provider Information

NPI Number	:	1962133470
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BEST CRANIAL CARE

Provider Business Mailing Address
First Line	:	8445 LAS VEGAS BLVD S APT 1057
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89123-1690
Country	:	US
Telephone Number	:	702-752-8354
Fax Number	:

Provider Business Practice Location Address
First Line	:	8445 LAS VEGAS BLVD S APT 1057
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89123-1690
Country	:	US
Telephone Number	:	702-752-8354
Fax Number	:	184-470-0137

Authorized Official
Title or Position	:	PROSTHETIC ORTHOTIC PROVIDER
Name	:	TATIANA RECHELLE NELSON
Credential	:	OTHER
Telephone Number	:	702-752-8354

Provider Enumeration Date	:	06/23/2022
Last Update Date	:	06/23/2022

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Directions to “BEST CRANIAL CARE ” Practice Location

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