Individual
EDGAR GOMEZ ENRIQUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6795 LILAC SKY AVE, LAS VEGAS, NV 89142-3620
(702) 738-1423
Mailing address
6795 LILAC SKY AVE, LAS VEGAS, NV 89142-3620
(702) 738-1423
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
—
—
Other
Enumeration date
06/19/2013
Last updated
06/19/2013
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