Individual
JUSTIN LAVONTE BLAGMON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3940 W ANN RD STE 100, NORTH LAS VEGAS, NV 89031-3845
(702) 820-8891
Mailing address
2315 MEDITERRANEAN SEA AVE, NORTH LAS VEGAS, NV 89031-0940
(661) 934-7297
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
04/09/2024
Last updated
04/09/2024
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