Individual
MS. AGUSTA DIANE GARY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6128 KAMI ST, NORTH LAS VEGAS, NV 89081-6688
(702) 632-3446
Mailing address
6128 KAMI ST, NORTH LAS VEGAS, NV 89081-6688
(702) 632-3446
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
—
—
Other
Enumeration date
12/25/2010
Last updated
12/25/2010
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