Provider Demographics
NPI:1386998128
Name:JM & JM CORP
Entity type:Organization
Organization Name:JM & JM CORP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JENNY
Authorized Official - Middle Name:
Authorized Official - Last Name:MOYA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-478-7785
Mailing Address - Street 1:7240 W AZURE DR
Mailing Address - Street 2:SUITE 165
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89130-4404
Mailing Address - Country:US
Mailing Address - Phone:702-478-7785
Mailing Address - Fax:702-478-8404
Practice Address - Street 1:7240 W AZURE DR
Practice Address - Street 2:SUITE 165
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89130-4404
Practice Address - Country:US
Practice Address - Phone:702-478-7785
Practice Address - Fax:702-478-8404
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-01
Last Update Date:2013-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty