Provider Demographics
NPI:1689695728
Name:ADVANTAGE HEALTH CARE INC
Entity Type:Organization
Organization Name:ADVANTAGE HEALTH CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:
Authorized Official - Last Name:FUST
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:702-434-2800
Mailing Address - Street 1:3663 E SUNSET RD STE 503
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89120-3299
Mailing Address - Country:US
Mailing Address - Phone:702-434-2800
Mailing Address - Fax:702-451-1034
Practice Address - Street 1:3663 E SUNSET RD STE 503
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89120-3299
Practice Address - Country:US
Practice Address - Phone:702-434-2800
Practice Address - Fax:702-451-1034
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Not Answered225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV32223Medicare ID - Type UnspecifiedGROUP