Individual
LANYNE JOELLE RUSSIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7824 PAPER FLOWER CT, LAS VEGAS, NV 89128-7328
(702) 259-0908
Mailing address
7824 PAPER FLOWER CT, LAS VEGAS, NV 89128-7328
(702) 259-0908
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
—
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1730214651
EAGLE QUEST OF NEVADA
NV
Enumeration date
08/18/2014
Last updated
08/18/2014
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