Facts
- Status
- A
- Credential
- CNA
- Type
- Individual
- Enumeration date
- 2024-07-11
- Last updated
- 2024-07-11
Specialties
Licenses
- License NV
- 873365
Location
- Practice location
- 3100 S NEEDLES HWY STE 600
- City
- LAUGHLIN NV
- Postal code
- 890290815
- Phone
- 702-868-1400
Medicare
- PECOS
- No PECOS enrollment row matched this NPI.
LEIE
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Nearby
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Removal request
Public data from NPPES and CMS. Not a credentialing determination.