Organization
GOLAN INTEGRATED PHYSICAL MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JASON JAEGER D.O (ADMINISTRATIVE DIRECTOR)
(702) 636-4990
Entity
Organization
Contact information
Practice address
6592 N DECATUR BLVD STE 115, LAS VEGAS, NV 89131-1038
(702) 369-4993
Mailing address
6592 N DECATUR BLVD STE 115, LAS VEGAS, NV 89131-1038
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
PA1667
NV
Other
Enumeration date
10/29/2015
Last updated
10/29/2015
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