# EXTREMITY RECONSTRUCTIVE LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1285019646
- **Authorized official:** DR. IRA WEINER DPM (OWNER)
- **Authorized official phone:** (702) 388-1006

## Contact information

- **Practice address:** 1703 CIVIC CENTER DR, SUITE \#3, NORTH LAS VEGAS, NV 89030-7212
- **Practice address phone:** (702) 388-1006
- **Practice address fax:** (702) 388-1751
- **Mailing address:** 1703 CIVIC CENTER DR, SUITE \#3, NORTH LAS VEGAS, NV 89030-7212
- **Mailing address phone:** (702) 388-1006
- **Mailing address fax:** (702) 388-1751

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | 9205 | NV | Yes |

## Other

- **Enumeration date:** 07/28/2015
- **Last updated:** 07/28/2015