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Organization

DESERT SHORES LLC

Active
Other names
DESERT SHORES LLC
Organization subpart
No

Provider details

NPI number
Authorized official
DR. TED A COHEN DPM (PRESIDENT)
(702) 339-8777
Entity
Organization

Contact information

Practice address
2235 N RAMPART BLVD, LAS VEGAS, NV 89128-7640
(702) 387-8777
Mailing address
2235 N RAMPART BLVD, LAS VEGAS, NV 89128-7640
(702) 387-8777

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
DPM9301
NV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
08442697
NV
Enumeration date
07/01/2015
Last updated
07/01/2015
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