Individual
JOHN BADGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3304 CONTERRA PARK AVE, NORTH LAS VEGAS, NV 89081-6537
(702) 685-1899
(702) 685-1799
Mailing address
4180 S PECOS RD, LAS VEGAS, NV 89121-5074
(702) 685-1899
(702) 685-1799
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
GF-125401000-0015
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
GF-125401000-0015
FACILITY NUMBER
NV
Enumeration date
02/08/2010
Last updated
02/08/2010
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