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Organization

INDIGO-BANE LLC

Active
Parent organization
INDIGO-BANE LLC
Other names
lo-go-pae-dics
Organization subpart
Yes

Provider details

NPI number
Legal business name
INDIGO-BANE LLC
Authorized official
MICHAEL LOPEZ (MANAGER)
(725) 255-5321
Entity
Organization

Contact information

Practice address
330 E WARM SPRINGS RD STE 122, LAS VEGAS, NV 89119-4281
(725) 255-5321
(725) 255-5323
Mailing address
330 E WARM SPRINGS RD STE 122, LAS VEGAS, NV 89119-4281
(725) 255-5321
(725) 255-5323

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary

Other

Enumeration date
05/03/2024
Last updated
05/03/2024
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