Individual
MR. FRIDAY A. ODONG
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Contact information
Practice address
4015 W CHARLESTON BLVD, LAS VEGAS, NV 89102-1612
(702) 457-0624
(702) 310-4653
Mailing address
2306 STOCKTON AVE, LAS VEGAS, NV 89104-3823
(702) 457-0624
(702) 310-4653
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
H13-00216-6-108724
NV
Other
Enumeration date
04/10/2006
Last updated
07/08/2007
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