Organization
PRO HEALTH PAIN & REHAB LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARC A RESASCO (OWNER)
(949) 281-9086
Entity
Organization
Contact information
Practice address
12744 WESTPORT PARKWAY, SUITE 1E, LAVISTA, NE 68138
(949) 281-9086
Mailing address
60 LORRAINE CT., HOLBOOK, NY 11741
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
—
—
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
208100000X
Physical Medicine & Rehabilitation Physician
—
—
208VP0014X
Interventional Pain Medicine Physician
Primary
—
NE
Other
Enumeration date
10/24/2016
Last updated
10/24/2016
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