Organization
WELLNESSREHAB PAIN MANAGEMENT CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM V QUIBA APRN, FNP-C (MANAGING MEMBER)
(702) 576-6102
Entity
Organization
Contact information
Practice address
5120 S PECOS RD, LAS VEGAS, NV 89120-1237
(702) 720-4624
(725) 224-0909
Mailing address
6720 N HUALAPAI WAY STE 145 BOX 312, BOX 312, LAS VEGAS, NV 89149
(702) 576-6102
Taxonomy
Speciality
Code
Description
License number
State
261QP3300X
Pain Clinic/Center
Primary
—
—
261QR0400X
Rehabilitation Clinic/Center
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
01/18/2024
Last updated
01/18/2024
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