Individual
BRIANNE WADTKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
405 PRAIRIE MOON AVE, NORTH LAS VEGAS, NV 89084-1257
(702) 534-0321
Mailing address
405 PRAIRIE MOON AVE, NORTH LAS VEGAS, NV 89084-1257
Taxonomy
Speciality
Code
Description
License number
State
1710I1003X
Independent Duty Medical Technicians
Primary
—
—
Other
Enumeration date
05/21/2012
Last updated
05/21/2012
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