Individual
KEKOA FUERTES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
720 W CHEYENNE AVE, SUITE 50, NORTH LAS VEGAS, NV 89030-7807
(702) 949-8622
(702) 947-8059
Mailing address
720 W CHEYENNE AVE, SUITE 50, NORTH LAS VEGAS, NV 89030-7807
(702) 949-8622
(702) 947-8059
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
—
—
Other
Enumeration date
10/12/2015
Last updated
10/12/2015
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