Provider Demographics
NPI:1649507864
Name:HOLISTIC SYNERGY
Entity type:Organization
Organization Name:HOLISTIC SYNERGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CONSTANTINO
Authorized Official - Middle Name:
Authorized Official - Last Name:ANASTASSIOU
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:702-240-0012
Mailing Address - Street 1:7501 W LAKE MEAD BLVD STE 114
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89128-0287
Mailing Address - Country:US
Mailing Address - Phone:702-240-0012
Mailing Address - Fax:702-240-0607
Practice Address - Street 1:7501 W LAKE MEAD BLVD STE 114
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-0287
Practice Address - Country:US
Practice Address - Phone:702-240-0012
Practice Address - Fax:702-240-0607
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-09
Last Update Date:2009-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVB01339111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty