Individual
DRAKETONIAL MACON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1001 MILLER AVE, LAS VEGAS, NV 89106-2257
(702) 320-4020
Mailing address
1001 MILLER AVE, LAS VEGAS, NV 89106-2257
(702) 320-4020
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
09/11/2015
Last updated
09/11/2015
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