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Individual

MARVELETTA KIRK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
6530 ANNIE OAKLEY DR, 512, HENDERSON, NV 89014-2167
(702) 239-6125
(702) 825-4873
Mailing address
6530 ANNIE OAKLEY DR, 512, HENDERSON, NV 89014-2167

Taxonomy

Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
NV20111675665
NV
Enumeration date
11/26/2011
Last updated
08/01/2016
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