Individual
DIMITRY KONSTANTINOV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1001 CORONADO CENTER DR, HENDERSON, NV 89052-3950
(702) 799-6800
Mailing address
10004 PERCEVAL ST, LAS VEGAS, NV 89183-6984
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
0506423
NV
Other
Enumeration date
08/05/2016
Last updated
08/05/2016
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