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Organization
FUNCTIONAL NEURO REHAB, LLC
Active
Organization
FUNCTIONAL NEURO REHAB, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHANNON MARIAH OLIVERO-CHEW O.T. (OWNER)
(575) 479-7056
Entity
Organization
Contact information
Practice address
650 WHITNEY RANCH DR APT 1511, HENDERSON, NV 89014-2615
(253) 261-8436
Mailing address
304 S JONES BLVD STE 3511, LAS VEGAS, NV 89107-2623
(575) 479-7056
Taxonomy
Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
Primary
—
NULL
Other
Enumeration date
11/30/2020
Last updated
09/06/2023
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