Organization
HCPN AT CITY IMPACT WELLNESS CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOSE VIRAY (OWNER)
(702) 871-9917
Entity
Organization
Contact information
Practice address
968 E SAHARA AVE STE C, LAS VEGAS, NV 89104-3022
(702) 871-9917
Mailing address
4850 W FLAMINGO RD STE 25, LAS VEGAS, NV 89103-3707
(702) 871-9917
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
03/11/2019
Last updated
03/11/2019
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