Individual
LEAH NICOLE RACINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4505 S MARYLAND PKWY, LAS VEGAS, NV 89154-9900
(702) 763-0150
Mailing address
410 DON PEDRO CIRCLE, NORTH LAS VEGAS, NV 89031
(702) 763-0150
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/26/2019
Last updated
06/26/2019
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