Individual
MISS BRANDY WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
336 LANCE AVE, NORTH LAS VEGAS, NV 89030-3869
(702) 610-9556
Mailing address
336 LANCE AVE, NORTH LAS VEGAS, NV 89030-3869
(702) 610-9556
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
—
—
Other
Enumeration date
09/14/2010
Last updated
05/24/2013
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