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Individual

DEANDRE NICHOLS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
3755 W LAKE MEAD BLVD, NORTH LAS VEGAS, NV 89032-4897
(702) 487-5665
Mailing address
4325 W ROME BLVD, APT #2014, NORTH LAS VEGAS, NV 89084-5497
(323) 649-7196

Taxonomy

Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
NV

Other

Enumeration date
12/28/2015
Last updated
12/28/2015
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