Provider Demographics
NPI:1831736693
Name:BACK 2 RELIEF VEGAS INC
Entity type:Organization
Organization Name:BACK 2 RELIEF VEGAS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RODOLFO
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTINEZ-FERRATE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:801-651-4283
Mailing Address - Street 1:PO BOX 971532
Mailing Address - Street 2:
Mailing Address - City:OREM
Mailing Address - State:UT
Mailing Address - Zip Code:84097-1532
Mailing Address - Country:US
Mailing Address - Phone:801-319-1120
Mailing Address - Fax:888-509-2322
Practice Address - Street 1:3455 E LAKE MEAD BLVD STE 1
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89030-7328
Practice Address - Country:US
Practice Address - Phone:702-642-1300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-28
Last Update Date:2019-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Multi-Specialty