Organization
AEVA CLINIC LLC
Active
Other names
Aeva Ageless Aesthetics Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
BARBARA DEINET (PRESIDENT)
(702) 219-6173
Entity
Organization
Contact information
Practice address
4641 BLUE DIAMOND RD STE 120A, LAS VEGAS, NV 89139-7610
(702) 558-2382
(702) 558-5407
Mailing address
6280 S VALLEY VIEW BLVD STE 734, LAS VEGAS, NV 89118-6833
(702) 558-2382
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
261Q00000X
Clinic/Center
—
—
261QH0100X
Health Service Clinic/Center
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
Other
Enumeration date
03/30/2018
Last updated
09/18/2018
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