Provider Information for 1063948966
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ORION BLOCK lsw
Sex: Female
NPI: 1063948966
Last Updated: 2025-02-27
Certification Date: 2025-02-27
Certification Date: 2025-02-27
Details
| Name | Value | ||||||||||||||||
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| NPI | 1063948966 | ||||||||||||||||
| Enumeration Date | 2017-05-11 | ||||||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||||||
| Sole Proprietor | YES | ||||||||||||||||
| Status | Active | ||||||||||||||||
| Mailing Address | 5915 S RAINBOW BLVD LAS VEGAS, ZZ United States Phone: 702-903-2677 | Fax: | ||||||||||||||||
| Primary Practice Address | 5915 S RAINBOW BLVD LAS VEGAS, NV 89118-2557 United States Phone: 702-209-0730 | Fax: | ||||||||||||||||
| Secondary Practice Address(es) | 6736 LAUREL CANYON BLVD STE 200 1 RICHMOND SQ STE 350W | ||||||||||||||||
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