Individual
JUAN MIGUEL LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
953 E SAHARA AVE STE A1, LAS VEGAS, NV 89104-3028
(702) 321-5152
Mailing address
30 DOVEWOOD AVE, LAS VEGAS, NV 89183-5670
(702) 321-5152
Taxonomy
Speciality
Code
Description
License number
State
332U00000X
Home Delivered Meals
Primary
—
—
Other
Enumeration date
10/25/2018
Last updated
10/25/2018
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