NPI 1346750676

Havoc City Boxing and Fitness

Organisation Health Maintenance Organization Las Vegas, NV

Practice location

Address: 9890 S Maryland Pkwy, Las Vegas, NV 89183-7166
Phone: (702) 588-3409
Mailing address: 1598 Sabatini Dr, Henderson, NV 89052-4127

Authorised official

Name: Brandon D Harris
Title: Opm
Phone: (702) 588-3409

Registered specialties

Health Maintenance Organization Primary

Managed Care Organizations Taxonomy 302R00000X

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Registry record

NPI: 1346750676
Entity type: Organization
NPI issued: 29 Sep 2017
Record last updated: 29 Sep 2017

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.