| Radiance Ketamine Clinic | |
|
5365 Mae Anne Ave Ste A10 Reno NV 89523-1841 | |
| (775) 432-1500 | |
| (775) 432-1002 |
| Full Name | Radiance Ketamine Clinic |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 5365 Mae Anne Ave Ste A10, Reno, Nevada |
| Authorized Official Name and Position | Greg Jones (CLINIC DIRECTOR) |
| Authorized Official Contact | 7752170332 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Radiance Ketamine Clinic 5365 Mae Anne Ave Ste A10 Reno NV 89523-1841 Ph: (775) 432-1500 | Radiance Ketamine Clinic 5365 Mae Anne Ave Ste A10 Reno NV 89523-1841 Ph: (775) 432-1500 |
| NPI Number | 1912543968 |
|---|---|
| Provider Enumeration Date | 11/25/2019 |
| Last Update Date | 08/27/2020 |
| Certification Date | 08/27/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912543968 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
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