Provider Demographics
NPI:1295559615
Name:TCM FOR WELLNESS LLC
Entity type:Organization
Organization Name:TCM FOR WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:APRN
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:V
Authorized Official - Last Name:QUIBA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:725-332-4294
Mailing Address - Street 1:5120 S PECOS RD
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89120-1237
Mailing Address - Country:US
Mailing Address - Phone:725-332-4294
Mailing Address - Fax:725-224-0909
Practice Address - Street 1:5120 S PECOS RD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89120-1237
Practice Address - Country:US
Practice Address - Phone:725-332-4294
Practice Address - Fax:725-224-0909
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-12
Last Update Date:2025-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty