Individual
GAYLE ALLENBACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSOT
Contact information
Practice address
5405 FOUNTAIN PALM ST, LAS VEGAS, NV 89130-3685
(702) 396-5710
Mailing address
5405 FOUNTAIN PALM ST, LAS VEGAS, NV 89130-3685
(702) 396-5710
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
0465
NV
Other
Enumeration date
01/03/2012
Last updated
01/03/2012
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