| Evolve Wellness Professional Corp | |
|
6859 S Eastern Ave Ste 103 Las Vegas NV 89119-0003 | |
| (702) 969-4021 | |
| Not Available |
| Full Name | Evolve Wellness Professional Corp |
|---|---|
| Speciality | Family Medicine |
| Location | 6859 S Eastern Ave Ste 103, Las Vegas, Nevada |
| Authorized Official Name and Position | Daryl Elder Lorenzo Escalona (CEO) |
| Authorized Official Contact | 7029694021 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Evolve Wellness Professional Corp 6859 S Eastern Ave Ste 103 Las Vegas NV 89119-0003 Ph: () - | Evolve Wellness Professional Corp 6859 S Eastern Ave Ste 103 Las Vegas NV 89119-0003 Ph: (702) 969-4021 |
| NPI Number | 1083447676 |
|---|---|
| Provider Enumeration Date | 08/21/2024 |
| Last Update Date | 08/21/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083447676 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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