Individual
EDMUNDO VILLANUEVA MASCARDO JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6889 S. EASTERN AVE., LAS VEGAS, NV 89119
(702) 434-1200
Mailing address
6430 BUTTERCUP CREEK ST, NORTH LAS VEGAS, NV 89084-1242
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
—
—
Other
Enumeration date
01/08/2015
Last updated
01/08/2015
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