Individual
MRS. MANUELITA PAVON PENALOSA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
6401 WEST CHARLESTON BOULEVARD, LAS VEGAS, NV 89146
(702) 259-7002
Mailing address
4306 THUNDER TWICE STREET, LAS VEGAS, NV 89129
(702) 340-4726
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
16396
NV
Other
Enumeration date
10/31/2011
Last updated
10/31/2011
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