Individual
MICHAEL IVANOFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
8225 W SAHARA AVE STE C, LAS VEGAS, NV 89117-8929
(702) 881-2813
Mailing address
8225 W SAHARA AVE STE C, LAS VEGAS, NV 89117-8929
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
3747P1801X
Personal Care Attendant
—
—
Other
Enumeration date
01/22/2024
Last updated
01/22/2024
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