Individual
MARIA BERNADETTE BASILIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6121 PEACH ORCHARD RD, LAS VEGAS, NV 89142-0949
(702) 285-1512
Mailing address
6121 PEACH ORCHARD RD, LAS VEGAS, NV 89142-0949
(702) 285-1512
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
12/06/2010
Last updated
12/06/2010
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