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Individual

TRAVISIA MINOR

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1120 N TOWN CENTER DR STE 120, LAS VEGAS, NV 89144-6302
(702) 743-9263
Mailing address
523 REDRUTH DR, LAS VEGAS, NV 89178-1285
(702) 743-9263

Taxonomy

Speciality
Code
Description
License number
State
227800000X
Certified Respiratory Therapist
Primary
RC799
NV

Other

Enumeration date
05/02/2012
Last updated
05/02/2012
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