Individual
EUGENE ENGRAM III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2220 ALISE ST, NORTH LAS VEGAS, NV 89030-4061
(323) 365-5544
Mailing address
7339 CROW CANYON AVE, LAS VEGAS, NV 89179-1246
(323) 365-5544
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
09/08/2021
Last updated
09/08/2021
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