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Individual

KENNETH MESA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
6649 PEPPERIDGE WAY, LAS VEGAS, NV 89108-5366
(702) 772-9505
Mailing address
6649 PEPPERIDGE WAY, LAS VEGAS, NV 89108-5366

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
12-1140
NV

Other

Enumeration date
11/04/2014
Last updated
11/04/2014
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