Organization
MEDELLA FAMILY CLINIC LLC
Active
Other names
Medella On The Go
Organization subpart
No
Provider details
NPI number
Authorized official
ALEXANDER RASAVONG (ADMINISTRATOR)
(725) 247-6858
Entity
Organization
Contact information
Practice address
4760 S PECOS RD STE 103-4, LAS VEGAS, NV 89121-6038
(725) 247-6858
Mailing address
4760 S PECOS RD STE 103-4, LAS VEGAS, NV 89121-6038
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
11/10/2022
Last updated
04/26/2023
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