Individual
KELLY CHARLES O'NEILL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BS
Contact information
Practice address
2325 WINDMILL PKWY APT 1312, HENDERSON, NV 89074-5450
(702) 807-7725
Mailing address
2325 WINDMILL PKWY APT 1312, HENDERSON, NV 89074-5450
(702) 807-7725
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
06/30/2012
Last updated
06/30/2012
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