Individual
MR. GWEN B DILLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1815 E LAKE MEAD, SUITE 103, N LAS VEGAS, NV 89030
(702) 839-0091
(702) 839-0095
Mailing address
P.O. BOX 26299, LAS VEGAS, NV 89126
(702) 893-3333
(702) 893-0960
Taxonomy
Speciality
Code
Description
License number
State
227800000X
Certified Respiratory Therapist
Primary
—
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1702161
—
NV
Enumeration date
10/13/2015
Last updated
10/13/2015
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