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Individual

MRS. BONITA JEAN GRABLE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1201 PAGENTRY DR, NORTH LAS VEGAS, NV 89031-2304
(702) 642-2697
Mailing address
1201 W PAGENTRY DRIVE, NORTH LAS VEGAS, NV 89031-2304
(702) 642-2697

Taxonomy

Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary

Other

Enumeration date
02/16/2011
Last updated
02/16/2011
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