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Individual

MS. JALISA SMITH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
6889 S. EASTERN AVE., LAS VEGAS, NV 89119-4687
(702) 434-1200
Mailing address
3509 TAYLOR AVE, NORTH LAS VEGAS, NV 89030-7431
(702) 528-0652

Taxonomy

Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary

Other

Enumeration date
12/10/2014
Last updated
12/29/2014
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