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Individual

BLAYSON A FAGBODUN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
3055 S NELLIS BLVD APT 1034, LAS VEGAS, NV 89121-7747
(702) 969-3512
Mailing address
3055 S NELLIS BLVD APT 1034, LAS VEGAS, NV 89121-7747
(702) 969-3512

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary

Other

Enumeration date
02/20/2023
Last updated
02/20/2023
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