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Organization

FORAGE PROFESSIONAL SERVICES PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JAMES FORAGE MD (SOLE MEMBER)
(800) 310-7334
Entity
Organization

Contact information

Practice address
10624 S EASTERN AVE # A443, HENDERSON, NV 89052-2982
(702) 896-0940
Mailing address
DEPT 880284 PO BOX 29650, PHOENIX, AZ 85038-9650
(800) 310-7334

Taxonomy

Speciality
Code
Description
License number
State
204R00000X
Electrodiagnostic Medicine Physician
Primary
10801
NV

Other

Enumeration date
07/26/2018
Last updated
04/10/2019
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