Organization
WOODWARD AVE., LLC
Active
Other names
dba Innovative Procedural and Surgical Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MATT PAXTON (MANAGER)
(702) 316-2281
Entity
Organization
Contact information
Practice address
9920 W CHEYENNE AVE, SUITE 120, LAS VEGAS, NV 89129-7725
(702) 316-2281
Mailing address
9920 W CHEYENNE AVE, SUITE 120, LAS VEGAS, NV 89129-7725
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
04/14/2011
Last updated
04/14/2011
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