| Glc Wellness | |
|
920 W Owens Ave Ste B Las Vegas NV 89106-2516 | |
| (702) 659-6910 | |
| (702) 659-6921 |
| Full Name | Glc Wellness |
|---|---|
| Speciality | General Practice |
| Location | 920 W Owens Ave Ste B, Las Vegas, Nevada |
| Authorized Official Name and Position | Brandy Allen (OWNER) |
| Authorized Official Contact | 7026596910 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Glc Wellness 8928 John Charles Ct Las Vegas NV 89149-4461 Ph: (702) 205-0428 | Glc Wellness 920 W Owens Ave Ste B Las Vegas NV 89106-2516 Ph: (702) 659-6910 |
| NPI Number | 1730867193 |
|---|---|
| Provider Enumeration Date | 07/06/2023 |
| Last Update Date | 08/12/2024 |
| Medicare PECOS PAC ID | 2769829506 |
|---|---|
| Medicare Enrollment ID | O20240328001358 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730867193 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Maxine B Ingham |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1730294455 PECOS PAC ID: 8325014541 Enrollment ID: I20101028000939 |
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