Organization
HAVOC CITY BOXING AND FITNESS
Active
Other names
Havoc City Boxing and fitness
Organization subpart
No
Provider details
NPI number
Authorized official
BRANDON D HARRIS (OPM)
(702) 588-3409
Entity
Organization
Contact information
Practice address
9890 S MARYLAND PKWY, LAS VEGAS, NV 89183-7166
(702) 588-3409
Mailing address
1598 SABATINI DR, HENDERSON, NV 89052-4127
(702) 588-3409
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
—
—
Other
Enumeration date
09/29/2017
Last updated
09/29/2017
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