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Individual

LOGAN RAY JEFFRIES

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
1831 STEVENS ST, LAS VEGAS, NV 89115-6312
(702) 493-0220
Mailing address
1831 STEVENS ST, LAS VEGAS, NV 89115-6312
(702) 466-3829

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary

Other

Enumeration date
07/31/2012
Last updated
07/31/2012
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  • EDI platform