| Michelle Gravley, P.c. | |
|
2445 Fire Mesa St Suite 190 Las Vegas NV 89128-9014 | |
| (702) 212-3008 | |
| (702) 933-3064 |
| Full Name | Michelle Gravley, P.c. |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 2445 Fire Mesa St, Las Vegas, Nevada |
| Authorized Official Name and Position | Michelle Gravley (OWNER/PRESIDENT) |
| Authorized Official Contact | 7022123008 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Michelle Gravley, P.c. 2445 Fire Mesa St Suite 190 Las Vegas NV 89128-9014 Ph: (702) 212-3008 | Michelle Gravley, P.c. 2445 Fire Mesa St Suite 190 Las Vegas NV 89128-9014 Ph: (702) 212-3008 |
| NPI Number | 1639470743 |
|---|---|
| Provider Enumeration Date | 11/04/2010 |
| Last Update Date | 11/04/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639470743 | NPI | - | NPPES |
| 002602018 | Medicaid | NV |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | PY0381 (Nevada) | Primary |
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