Organization
KETAMINAMD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MATTHEW SESSA (AUTHORIZING REPRESENTATIVE)
(929) 494-1182
Entity
Organization
Contact information
Practice address
930 S 4TH ST STE 209, LAS VEGAS, NV 89101-6845
(929) 494-1182
(929) 494-1182
Mailing address
930 S 4TH ST STE 209, LAS VEGAS, NV 89101-6845
(929) 494-1182
(929) 494-1182
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
11/27/2023
Last updated
06/19/2024
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