Provider Demographics
NPI:1215661574
Name:RYSE N SHINE WELLNESS LLC
Entity type:Organization
Organization Name:RYSE N SHINE WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:RYSER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-382-5115
Mailing Address - Street 1:4132 S RAINBOW BLVD # 476
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89103-3106
Mailing Address - Country:US
Mailing Address - Phone:760-382-5115
Mailing Address - Fax:702-825-7893
Practice Address - Street 1:70 S HIGHWAY 160
Practice Address - Street 2:UNIT 101
Practice Address - City:PAHRUMP
Practice Address - State:NV
Practice Address - Zip Code:89048
Practice Address - Country:US
Practice Address - Phone:760-382-5115
Practice Address - Fax:702-825-7893
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-13
Last Update Date:2022-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth ServiceGroup - Multi-Specialty