Individual
EDWARD JIMENEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2650 N TENAYA WAY, #180, LAS VEGAS, NV 89128-1102
(702) 952-3653
Mailing address
6129 THORNDIKE CT, LAS VEGAS, NV 89130-1383
(702) 839-0112
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1733
LICENSE #
NV
Enumeration date
08/29/2006
Last updated
07/08/2007
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