Individual
LISA DENISE SANFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2750 W WIGWAM AVE APT 2169, LAS VEGAS, NV 89123-6656
(323) 706-2161
Mailing address
2750 W WIGWAM AVE APT 2169, LAS VEGAS, NV 89123-6656
(323) 706-2161
Taxonomy
Speciality
Code
Description
License number
State
171000000X
Military Health Care Provider
Primary
—
—
Other
Enumeration date
09/11/2018
Last updated
09/11/2018
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