Provider Demographics
NPI:1033366521
Name:PASQUALE J LAURITO PLLC
Entity Type:Organization
Organization Name:PASQUALE J LAURITO PLLC
Other - Org Name:COMPLETE CARE INJURY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:PASQUALE
Authorized Official - Middle Name:J
Authorized Official - Last Name:LAURITO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:702-870-2007
Mailing Address - Street 1:2401 W CHARLESTON BLVD
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89102-2123
Mailing Address - Country:US
Mailing Address - Phone:702-312-0561
Mailing Address - Fax:702-312-0614
Practice Address - Street 1:2325 W CHARLESTON BLVD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89102
Practice Address - Country:US
Practice Address - Phone:702-312-0561
Practice Address - Fax:702-312-0614
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-26
Last Update Date:2018-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVB617111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty