| Sspc1 LLC | |
|
3097 S Decatur Blvd Las Vegas NV 89102-9130 | |
| (702) 272-0634 | |
| Not Available |
| Full Name | Sspc1 LLC |
|---|---|
| Speciality | Internal Medicine |
| Location | 3097 S Decatur Blvd, Las Vegas, Nevada |
| Authorized Official Name and Position | Christopher Milford (MEMBER) |
| Authorized Official Contact | 7022720694 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sspc1 LLC 9811 W Charleston Blvd Ste 2 Las Vegas NV 89117-7519 Ph: (702) 272-0694 | Sspc1 LLC 3097 S Decatur Blvd Las Vegas NV 89102-9130 Ph: (702) 272-0634 |
| NPI Number | 1710414834 |
|---|---|
| Provider Enumeration Date | 05/19/2017 |
| Last Update Date | 05/19/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710414834 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | () | Primary |
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