Organization
VIDA WELLNESS CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CRYSTAL BARBER (COO)
(702) 906-9700
Entity
Organization
Contact information
Practice address
7670 W SAHARA AVE STE 2, LAS VEGAS, NV 89117-2751
(702) 457-7401
Mailing address
7670 W SAHARA AVE STE 2, LAS VEGAS, NV 89117-2751
(702) 457-7401
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11016
STATE OF NEVADA
NV
Enumeration date
07/18/2019
Last updated
07/18/2019
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