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Individual

JESUS FERNANDEZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
4660 S EASTERN AVE, 200, LAS VEGAS, NV 89119-6137
(702) 451-7542
(702) 450-4239
Mailing address
4660 S EASTERN AVE, 200, LAS VEGAS, NV 89119-6137
(702) 451-7542
(702) 450-4239

Taxonomy

Speciality
Code
Description
License number
State
172A00000X
Driver
Primary

Other

Enumeration date
10/24/2011
Last updated
10/24/2011
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