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Individual

MR. PHILLIP CLAYON STAFFORD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
7213 CHESTERTON DR, LAS VEGAS, NV 89128-3121
(702) 754-9136
Mailing address
7055 E LAKE MEAD BLVD, APT 1004, LAS VEGAS, NV 89156-1108
(804) 729-1264

Taxonomy

Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary

Other

Enumeration date
02/26/2017
Last updated
08/05/2021
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