Organization
LAS VEGAS PAIN RELIEF CENTERS(RUSSO),PC
Active
Organization
LAS VEGAS PAIN RELIEF CENTERS(RUSSO),PC
Active
Other names
Las Vegas Pain Relief Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JON S PETRICK D.C. (CLINICAL DIRECTOR)
(702) 948-2520
Entity
Organization
Contact information
Practice address
58 N PECOS RD, HENDERSON, NV 89074-7319
(702) 948-2520
(702) 948-2523
Mailing address
58 N PECOS RD, HENDERSON, NV 89074-7319
(702) 948-2520
(702) 948-2523
Taxonomy
Speciality
Code
Description
License number
State
111NS0005X
Sports Physician Chiropractor
B00848
NV
207RS0010X
Sports Medicine (Internal Medicine) Physician
Primary
4511
NV
Other
Enumeration date
04/12/2013
Last updated
03/02/2015
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