Individual
BAKARI MAALIK FORTMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
820 RANCHO LN STE 40, LAS VEGAS, NV 89106-3806
(702) 366-0875
Mailing address
820 RANCHO LN STE 40, LAS VEGAS, NV 89106-3806
(702) 366-0875
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
—
—
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Enumeration date
08/17/2021
Last updated
08/17/2021
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