Organization
A-GRAV 1 LLC
Active
Organization
A-GRAV 1 LLC
Active
Other names
MOON WALK CARDIO
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DENNIS LAVERN DUBOIS (MANAGING MEMBER)
(702) 373-8151
Entity
Organization
Contact information
Practice address
365 E WINDMILL LN, LAS VEGAS, NV 89123-1807
(702) 675-3569
(702) 701-9413
Mailing address
2375 E TROPICANA AVE # 271, LAS VEGAS, NV 89119-6564
(702) 675-3569
(702) 701-9413
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
—
—
261QP2000X
Physical Therapy Clinic/Center
—
—
Other
Enumeration date
03/29/2013
Last updated
03/29/2013
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