Provider Demographics
NPI:1164631693
Name:TREVELYNN HENUSET LTD
Entity Type:Organization
Organization Name:TREVELYNN HENUSET LTD
Other - Org Name:PERFORMANCE HEALTH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TREVELYNN
Authorized Official - Middle Name:DEAN
Authorized Official - Last Name:HENUSET
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:702-966-5920
Mailing Address - Street 1:866 SEVEN HILLS DR
Mailing Address - Street 2:#102
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89052-4374
Mailing Address - Country:US
Mailing Address - Phone:702-966-5920
Mailing Address - Fax:702-307-9193
Practice Address - Street 1:866 SEVEN HILLS DR
Practice Address - Street 2:#102
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052-4374
Practice Address - Country:US
Practice Address - Phone:702-966-5920
Practice Address - Fax:702-307-9193
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVB00970111N00000X, 111NR0400X
CADC27607111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Not Answered111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Multi-Specialty