Individual
MS. KATHY ROARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4194 SANTA TERRASA PL, LAS VEGAS, NV 89121-6436
(702) 451-8285
Mailing address
4194 SANTA TERRASA PL, LAS VEGAS, NV 89121-6436
(702) 451-8285
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
—
—
Other
Enumeration date
04/21/2011
Last updated
04/21/2011
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