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Organization
HAVOC CITY BOXING AND FITNESS
Active
Organization
HAVOC CITY BOXING AND FITNESS
Active
Other names
Havoc City Boxing and fitness
Organization subpart
No
Provider details
NPI number
Authorized official
BRANDON D HARRIS (OPM)
(702) 588-3409
Entity
Organization
Contact information
Practice address
9890 S MARYLAND PKWY, LAS VEGAS, NV 89183-7166
(702) 588-3409
Mailing address
1598 SABATINI DR, HENDERSON, NV 89052-4127
(702) 588-3409
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
—
—
Other
Enumeration date
09/29/2017
Last updated
09/29/2017
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