Provider Demographics
NPI:1982236667
Name:LASER PAIN RELIEF CENTER
Entity Type:Organization
Organization Name:LASER PAIN RELIEF CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LASER THERAPIST, BUSINESS DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:M
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:775-544-5864
Mailing Address - Street 1:150 COUNTRY ESTATES CIR STE 120
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89511-4017
Mailing Address - Country:US
Mailing Address - Phone:775-544-5864
Mailing Address - Fax:775-583-5400
Practice Address - Street 1:150 COUNTRY ESTATES CIR STE 120
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89511-4017
Practice Address - Country:US
Practice Address - Phone:775-544-5864
Practice Address - Fax:775-583-5400
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LASER PAIN RELIEF CENTER LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-02-10
Last Update Date:2020-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPain