# EDDIEPMD INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Advanced Spine & Pain Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1306934443
- **Authorized official:** LARRY ROBINSON (PRACTICE ADMINISTRATOR)
- **Authorized official phone:** (702) 386-0909

## Contact information

- **Practice address:** 601 S RANCHO DR, STE A-6, LAS VEGAS, NV 89106-4899
- **Practice address phone:** (702) 386-0909
- **Practice address fax:** (702) 386-0707
- **Mailing address:** 840 S RANCHO DR, STE. \#4-338, LAS VEGAS, NV 89106-3837
- **Mailing address phone:** (702) 386-0909
- **Mailing address fax:** (702) 386-0707

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | NULL | Yes |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | — | Yes |

## Other

- **Enumeration date:** 10/11/2006
- **Last updated:** 11/14/2018